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Hyperreactio luteinalis in a normal singleton pregnancy. A case report

Z Csapó1, I Szabó, M Tóth

  • 1Department of Obstetrics and Gynecology, Semmelweis University Medical School, Budapest, Hungary. csapo@noi1.sote.hu

The Journal of Reproductive Medicine
|February 13, 1999
PubMed
Summary

Hyperreactio luteinalis, a rare ovarian enlargement in pregnancy, can present with high human chorionic gonadotropin (hCG) and hyperandrogenism. Early ultrasonography is crucial for diagnosing this condition in pregnant patients.

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Area of Science:

  • Reproductive Endocrinology
  • Obstetrics and Gynecology
  • Pathology

Background:

  • Hyperreactio luteinalis is a rare condition characterized by enlarged ovaries, typically associated with multiple gestations or molar pregnancies.
  • This case report details an unusual instance of hyperreactio luteinalis in a normal singleton pregnancy.

Observation:

  • A pregnant patient presented with significantly enlarged, bilateral, cystic ovaries detected via ultrasonography at 28 weeks gestation.
  • Elevated levels of androgens and human chorionic gonadotropin (hCG) were observed, alongside worsening hyperandrogenism over six weeks.
  • Surgical intervention (Cesarean section, adnexectomy, and ovarian resection) was performed due to the enlarging ovarian masses.

Findings:

  • Histological examination confirmed the diagnosis of hyperreactio luteinalis.

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  • The condition was associated with an idiopathic elevation of hCG and a hyperandrogenic state.
  • The placenta showed no abnormalities.

    • Implications:

    • This case highlights that hyperreactio luteinalis with elevated hCG can occur in normal singleton pregnancies.
    • It underscores the importance of routine ovarian ultrasonography, even in late pregnancy, for early detection and management.
    • Prompt diagnosis and management are essential to prevent complications associated with ovarian enlargement and hormonal imbalances during pregnancy.