[Rapidly progressing thrombocytopenia as a threatening form of pre-eclampsia]

Atypical courses of pregnancy-induced hypertension (PIH) have been reported quite frequently during the last time. They include prepartal coagulation disorders with slight or missing typical symptoms of PIH. In cases of quickly increasing thrombocytopenia during the last trimenon, in company with elevated liver enzymes, PIH must always be taken into account. We give a case report about a nearly asymptomatic secundigravid woman who developed low platelet counts (8,000 platelets/microliter) within a few hours, which later was confirmed to be severe preeclampsia. Transient and moderate thrombocytopenia down to 50,000 platelets/microliter caused by PIH may first be treated conservatively. Progredient symptoms should lead to an early delivery, as neonatal mortality in such cases is high. We give a review about current literature which reflects on differential diagnosis, pathogenesis and therapy of this disease.