HELLP syndrome (hemolysis, elevated liver enzymes and low platelets) represents a severe form of preeclampsia associated with serious maternal and fetal morbidities and even death. Usually HELLP syndrome appears during the evolution of a severe preeclampsia; however HELLP syndrome can have atypical clinical manifestations. We report a 22 years old female who consulted at 20 weeks of pregnancy for lumbar pain, dysuria and fever. A urinalysis revealed the presence of white blood cells. The patient was admitted to hospital and treated with antimicrobials. Forty eight hours after admission a proteinuria of 440 mg/24h was detected. A severe pre eclampsia-HELLP syndrome was diagnosed. However the patient remained with normal blood pressure. An elevation of liver enzymes and creatinine were observed. Five days later fetal death was confirmed and an abortion was induced. The patient required a platelet transfusion. Four days after the abortion, the patient was discharged in good conditions.Preeclampsia es un cuadro de hipertensión que se desarrolla en una embarazada, previamente normotensa, después de las 20 semanas. Los criterios diagnósticos de preeclampsia son presión arterial elevada (sistólica >140 mmHg o diastólica >90 mmHg) y proteinuria (>300 mg/24-h). El síndrome HELLP (hemólisis, elevación de enzimas hepáticas y plaquetas bajas) representa una forma severa de preeclampsia, asociada con morbilidad severa y mortalidad materna y fetal. Habitualmente el HELLP aparece durante la evolución de una preeclampsia severa; sin embargo, el HELLP puede tener manifestaciones atípicas. Reportamos un caso inusual de una mujer quien desarrolla un HELLP pero permanece con presión arterial normal.