title: Hyperreactio luteinalis with both markedly elevated human chorionic gonadotropin levels and an imbalance of angiogenic factors subsequently developed severe early-onset preeclampsia.
abstract: 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).
  
  
  METHODS
  Case report.
  
  
  METHODS
  University perinatal center.
  
  
  METHODS
  A 32-year-old primigravida woman with HL, high hCG levels, and severe imbalance of angiogenic factors who subsequently developed severe PE.
  
  
  METHODS
  Emergent cesarean section due to nonreassuring fetal status.
  
  
  METHODS
  Severe, early onset PE.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan. masuyama@cc.okayama-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masuyama
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tateishi
authors.forename: Miwa
authors.initials: M
authors.lastname: Matsuda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatrsu
mesh_terms: D000328:Adult; D002585:Cesarean Section; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D010048:Ovarian Cysts / Q000150:complications* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology; D011257:Pregnancy Proteins / Q000097:blood; D014463:Ultrasonography
chemical_list: D006063:Chorionic Gonadotropin; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor