Hyperreactio luteinalis, a rare cause of hyperthyroidism in pregnancy

Hyperreactio luteinalis associated with fetal hyperandrogenism and cystic hygroma

“… 13 The laboratory results in our patient may indicate a slight degree of subclinical hyperthyroidism, as physiologic TSH levels in the first trimester of pregnancy can range from 0.03 to 2.5 mU/L. 11 The tumor marker CA‐125 was slightly elevated in our patient (62.1, normal level up to 35 IU/ml). Due to ovarian cells hypertrophy, an elevation of CA‐125 can be anticipated in association with HL, and values up to 442 IU/ml were reported in the literature without indicating malignancy.…”

“…On the other hand, primary HL can be associated with TSH suppression due to the negative feedback effects of hCG on the pituitary‐thyroid axis 13 . The laboratory results in our patient may indicate a slight degree of subclinical hyperthyroidism, as physiologic TSH levels in the first trimester of pregnancy can range from 0.03 to 2.5 mU/L 11 . The tumor marker CA‐125 was slightly elevated in our patient (62.1, normal level up to 35 IU/ml).…”

“… 3 Both hypothyroidism and hyperthyroidism were reported in patients with HL. 11 , 12 Patients with pre‐existing hypothyroidism show elevated levels of thyroid‐stimulating hormone (TSH), which can activate hCG receptors and induce secondary hyperreactio luteinalis. 12 On the other hand, primary HL can be associated with TSH suppression due to the negative feedback effects of hCG on the pituitary‐thyroid axis.…”

“…Many cases are discovered incidentally, either with ultrasound or during cesarean section, whereas symptomatic cases usually present with abdominal discomfort or pain 3 . Both hypothyroidism and hyperthyroidism were reported in patients with HL 11,12 . Patients with pre‐existing hypothyroidism show elevated levels of thyroid‐stimulating hormone (TSH), which can activate hCG receptors and induce secondary hyperreactio luteinalis 12 .…”