Acute Severe Pancreatitis in Pregnancy Masquerading as Partial Hemolysis Elevated Liver enzymes Low Platelet (HELLP) Syndrome

Acute severe pancreatitis may result in biochemical abnormalities resembling those seen in Hemolysis Elevated Liver enzymes Low Platelet (HELLP) Syndrome. A 17-year-old female with 27 weeks of gestation presented mild acute pancreatitis. Based on the criteria of persistent Systemic Inflammatory Response Syndrome (SIRS) she subsequently developed severe pancreatitis. Bilirubin 2.2 mg/dL, lactate dehydrogenase 2171 IU/L and platelet of 53000 mm3 after 48 hours of the onset of pain, also indicated the possibility of partial HELLP syndrome. However, the results of the differential diagnosis ruled out the presence of Disseminated Intravascular Coagulation (DIC), Thrombotic Thrombocytopenic Purpura (TTP), Systemic Lupus Erythematosus (SLE) and Anti phospholipids syndrome. We terminated her pregnancy due to the above-mentioned diagnoses and postponed the cholecystectomy. Termination of pregnancy was performed as it would save the patient’s life in either deteriorated acute severe pancreatitis or HELLP.