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The term HELLP syndrome (an acronym of haemolysis, elevated liver enzyme, and low platelets) represents a severe variant of preeclampsia-eclampsia. It was described in these last years. The interpretation of elevated liver enzymes, the presence of haemolysis, and the platelets consumption are clinical pictures of internal physician interest (represented by an emergentist). We describe a case report and revised the recent literature, particularly the therapeutic aspects on the role of steroids. They are still object of studies and their use is not unanimously shared.