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DOI: 10.1055/s-2006-931910
Hyperreactio Luteinalis Presenting with Marked Hyperglycemia and Bilateral Multicystic Adnexal Masses at 21 Weeks Gestation
Publikationsverlauf
Publikationsdatum:
10. Februar 2006 (online)
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ABSTRACT
We present an unusual case in which a 23-year-old nulliparous patient was noted to have bilateral multicystic adnexal masses at 21 weeks gestation. Subsequent severe nausea, vomiting, and hyperglycemia with a serum glucose level of 450 mg/dL led to the diagnosis of gestational diabetes. Gradual development of marked maternal virilization ensued and was associated with a serum testosterone level of 4030 ng/mL (free testosterone level of 224 pg/mL), with normal serum dehydroepiandrostendione, estriol, and cortisol levels, leading to the diagnosis of hyperreactio luteinalis. Following vaginal delivery at 38 weeks gestation, gradual and complete spontaneous resolution of signs, symptoms, adnexal masses, diabetes, and testosterone levels were documented.
KEYWORDS
Hyperreaction luteinalis - polycystic ovarian disease - gestational diabetes - maternal virilization - pregnancy - adnexal masses
REFERENCES
- 1 Haimov-Kochman R, Yanai N, Yagel S, Amsalem H, Lavy Y, Hurwitz A. Spontaneous ovarian hyperstimulation syndrome and hyperreactio luteinalis are entities in continuum. Ultrasound Obstet Gynecol. 2004; 24 675-678
- 2 Suzuki S. Comparison between spontaneous ovarian hyperstimulation syndrome and hyperreactio luteinalis. Arch Gynecol Obstet. 2004; 269 227-229
- 3 Foulk R A, Martin M C, Jerkins G L, Laros R K. Hyperreactio luteinalis differentiated from severe ovarian hyperstimulation syndrome in a spontaneously conceived pregnancy. Am J Obstet Gynecol. 1997; 176 1300-1302
- 4 Bidus M S, Ries A, Magann E F, Martin J N. Markedly elevated beta-hCG levels in a normal singleton gestation with hyperreactio gestationalis. Obstet Gynecol. 2002; 99 958-961
- 5 Schnorr J A, Miller H, Davis J R, Hatch K, Seeds J. Hyperreaction luteinalis associated with pregnancy: a case report and review of the literature. Am J Perinatol. 1996; 13 95-97
- 6 Chiang G, Levine D. Imaging of adnexal masses in pregnancy. J Ultrasound Med. 2004; 23 805-819
- 7 Ghosain M A, Buy J N, Ruiz A et al.. Hyperreactio luteinalis in a normal pregnancy: sonographic and MRI findings. J Magn Reson Imaging. 1998; 8 1203-1206
- 8 Lambers D S, Rosenn B. Hyperreactio luteinalis complicating a normal singleton pregnancy. Am J Perinatol. 1996; 13 491-494
- 9 Wajda K J, Lucas J G, Marsh W L. Hyperreactio luteinalis. Benign disorder masquerading as an ovarian neoplasm. Arch Pathol Lab Med. 1989; 113 921-925
- 10 Yapar E G, Vural Ekici E, Kuscu E, Gokmen O. Hyperreactio luteinalis masquerading as an ovarian neoplasm in a triplet pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996; 65 177-180
- 11 Radon P A, McMahone M J, Meyer W R. Impaired glucose tolerance in pregnant women with polycystic ovary syndrome. Obstet Gynecol. 1999; 94 194-197
- 12 Kousta E, Cela E, Lawrence N, et al. The prevalence of polycystic ovaries in women with a history of gestational diabetes. Clin Endocrinol. 2000; 53 501-507
- 13 Pugeat M, Ducluzeau P H, Mallion-Donadieu M. Association of insulin resistance with hyperandrogenia in women. Horm Res. 2000; 54 322-326
- 14 Glintborg D, Henriksen J E, Andersen M et al.. Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 Caucasian premenopausal women with hirsutism as the referral diagnosis. Fertil Steril. 2004; 82 1570-1579
- 15 Moghetti P, Tosi F, Castello R et al. The insulin resistance in women with hyperandrogenism is partially reversed by antiandrogen treatment: evidence that androgens impair insulin action in women. J Clin Endocrinol Metab. 1996; 81 952-960
David M ShererM.D.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Medical Center
445 Lenox Road, Box 24, Brooklyn, NY 11203-2098