[Diagnostic problems in HELLP syndrome--presented with reference to 20 case reports].

15 so-called "definite" cases and five so-called "questionable" cases of HELLP-Syndrome are reported and discussed. The cases demonstrate the chameleon-like behaviour of symptoms and how difficult it can be to avoid it's full manifestation even if careful attention is paid to liver enzymes or platelets. Elevated liver enzymes and low platelets are also found in normal pregnancies making differential diagnosis more difficult as the retrospective analysis of laboratory findings of more than 2000 normal pregnancies shows. Even though, careful attention should be paid to detect any early laboratory finding or clinical sign of HELLP-Syndrome in order to prevent dramatic outcomes. Any symptoms of gestosis should be reason to determine not only liver enzymes and platelets, but also haptoglobin as the latter seems to detect early hemolysis in a beginning HELLP-Syndrome.