title: Hyperreactio luteinalis presenting with marked hyperglycemia and bilateral multicystic adnexal masses at 21 weeks gestation.
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.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York.
authors.forename: David M
authors.initials: DM
authors.lastname: Sherer
authors.forename: Mudar
authors.initials: M
authors.lastname: Dalloul
authors.forename: Fady
authors.initials: F
authors.lastname: Khoury-Collado
authors.forename: Mira
authors.initials: M
authors.lastname: Hellman
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Osho
authors.forename: Roopa S P
authors.initials: RS
authors.lastname: Gupta
authors.forename: Ovadia
authors.initials: O
authors.lastname: Abulafia
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis* / Q000628:therapy; D010298:Parity; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D012075:Remission, Spontaneous; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal; D014770:Virilism / Q000175:diagnosis