Our service received a thirty-year old female patient, primigravida, with 32.1 weeks of gestational age, severe toxemia and icteric. Initial treatment consisted of hydralazine, nifedipine and magnesium sulfate. Stabilization was obtained interrupting pregnancy. Laboratory tests showed hyperbilirubinemia and prolonged blood coagulation tests. Radiologic, endoscopic and other special diagnostic procedures were not conclusive. Histopathology gave a definitive diagnosis. A team approach management was required.