Hyperreactio luteinalis with both markedly elevated human chorionic gonadotropin levels and an imbalance of angiogenic factors subsequently developed severe early-onset preeclampsia

Objective

To report a case of hyperreactio luteinalis (HL) with elevated levels of human chorionic gonadotropin (hCG) and a severe imbalance of angiogenic factors, which developed into severe, early onset preeclampsia (PE).

Design

Case report.

Setting

University perinatal center.

Patient(s)

A 32-year-old primigravida woman with HL, high hCG levels, and severe imbalance of angiogenic factors who subsequently developed severe PE.

Intervention(s)

Emergent cesarean section due to nonreassuring fetal status.

Main Outcome Measure(s)

Severe, early onset PE.

Result(s)

A case of HL was referred to our hospital for remarkably elevated hCG levels and bilaterally enlarged multicystic ovaries in the first trimester; the patient subsequently developed severe, early onset PE with a severe imbalance of angiogenic factors. Emergency cesarean section was performed, and she delivered a premature female infant weighing 1818 g at 32 week's gestational age. During her next pregnancy, the circulating levels of hCG and angiogenic factors remained normal, and she did not develop either PE or HL.

Conclusion(s)

Although HL complicated with PE is very rare, our case suggests that HL associated with both an elevated hCG level and an imbalance of angiogenic factors might be a risk/predictive factor for severe, early onset PE.

Key Words: Angiogenic factor, hyperreactio luteinalis, human chorionic gonadotropin, preeclampsia