Question of the month ( March 2000 )
Considering that morphologic evidence, in most instances, is the strongest supporting fact in diagnostic dilemmas, and that an overwhelming information provided by autopsy material coupled with kidney and liver biopsies in some living patients have demonstrated that in pre-eclampsia-eclampsia two lesions should be considered if not specific at least pathognomonic; glomerular endotheliosis and periportal hemorrhagic necrosis.
Considering that many fatal cases in pre-eclampsia-eclampsia complicated by hemorrhagic disorders (coagulopathies) during the first 80 years of the XX century showed both lesions, among many others (depending of the main cause of death), and therefore were included as complications or diverse clinical expressions of the pre-eclamptic syndrome.
What new evidence is there to consider the so-called HELLP syndrome as a different or separate entity of the pre-eclampsia-eclampsia syndrome if all patients dying from it or from any other hemorrhagic complication associated or precipitated by the pre-eclamptic condition show, among many other multisystemic changes, the main two lesions: periportal hemorrhagic necrosis and glomerular endotheliosis or , When and why did these two lesions become worthless as diagnostic tools?
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