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.