Hyperreactio Luteinalis with early-onset HELLP syndrome: A case report


Ashraf Jamal 1 , Azin Alavi 2 , * , Sanaz Moosavi 3

1 Professor Department of Obstetrics and Gynecology, Tehran University of Medicla Sciences, Tehran, Iran.

2 Assistant Professor Department of Obstetrics and Gynecology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

3 Assistant Professor Department of Obstetrics and Gynecology, Tebriz University of Medical Sciences, Tabriz, Iran.

How to Cite: Jamal A, Alavi A, Moosavi S . Hyperreactio Luteinalis with early-onset HELLP syndrome: A case report, Hormozgan Med J. 2016 ; 19(6):e87657.


Hormozgan Medical Journal: 19 (6); e87657
Published Online: July 01, 2015
Article Type: Case Report
Received: November 05, 2014
Accepted: July 01, 2015


Introduction: Hyperreactio Luteinalis (HL) is a rare benign condition in pregnancy
which is characterized by bilaterally multicystic ovarian enlargement containing theca
lutein cysts caused by increased production of hCG. HL is mostly associated with
hydatidiform mole and multiple pregnancies.
Case Report: We report a unique case of hyperreactio Luteinalis (HL) in spontaneous
singleton pregnancy with elevated level of human chorionic gonadotropin (hCG) and
alpha-fetoprotein (AFP) for who referred to our center for high blood pressure and
proteinuria which subsequently developed early–onset HELLP syndrome (hemolysis,
elevated liver enzymes, and low platelet count) at 18 weeks of pregnancy. Termination of
pregnancy was considered and a patient passed a normal dead fetus. Placental histology
showed evidence of hypoperfusion with focal villous infarction and ischemic changes
without evidence of trophoblastic abnormalities.
Conclusion: Hyperreactio luteinalis associating with high level of hCG in second
trimester can be consequence of inadequate trophoblast invasion and may be a risk factor
for early onset HELLP syndrome.



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