ACUTE EXACERBATED LUPUS-ERYTHEMATOSUS - D IFFERENTIAL-DIAGNOSIS OF A HELLP-SYNDROME

The term HELLP-syndrome was inaugurated by Weinstein in 1982 and is ch aracterised by the following trias in patients with pregnancy-induced hypertonia (PIH): haemolysis, elevated liver enzymes, low platelets. I n recent years cases of ''incomplete'' HELLP-syndrome have been report ed which lack some of the symptoms. With increasing awareness of this disease among obstetricians the reported incidence is increasing. Undo ubtedly some patients are misclassified as having HELLP-syndrome and c onsequently receive inadequate therapy. Other pregnancy-induced altera tions or selected diseases in internal medicine may mimick symptoms of HELLP-syndrome. To stress the necessity for considering differential diagnoses in patients with HELLP-syndrome, we report on the following clinical observation. A 23-year old patient was referred to our hospit al under diagnosis of HELLP-syndrome during her 33 + 2(nd) week of ges tation. Because of a pathologic cardiotocogram and urgent C-section wa s performed. After birth the patient was diagnosed of having a systemi c Lupus erythematosus which was aggravated during pregnancy.