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February 24, 1999

HELLP Syndrome—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(8):703-705. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-8-jbk0224

In Reply: Drs Minakami and Sato point out that thrombocytopenia may be an early manifestation of impending HELLP syndrome and suggest that my wife's platelet count may have declined gradually to the level that led to the diagnosis only when she was critically ill. Their comment makes an important point: HELLP syndrome does not occur overnight. Rather, subtle symptoms and signs of this disorder may be present for days (or even weeks, in some cases) before the onset of crisis and may be detected with careful surveillance.