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Chauhan YV, Dalwadi PP, Gada JV, et al. Unrecognized Primary Hypothyroidism As a Possible Cause of Hyperreactio Luteinalis. Cureus. 2021;13(2):e13573doi: 10.7759/cureus.13573.
Chauhan, Y. V., Dalwadi, P. P., Gada, J. V., Varthakavi, P. K., & Bhagwat, N. (2021). Unrecognized Primary Hypothyroidism As a Possible Cause of Hyperreactio Luteinalis. Cureus, 13(2), e13573. https://doi.org/10.7759/cureus.13573
Chauhan, Yash V, et al. "Unrecognized Primary Hypothyroidism As a Possible Cause of Hyperreactio Luteinalis." Cureus vol. 13,2 (2021): e13573. doi: https://doi.org/10.7759/cureus.13573
Chauhan YV, Dalwadi PP, Gada JV, Varthakavi PK, Bhagwat N. Unrecognized Primary Hypothyroidism As a Possible Cause of Hyperreactio Luteinalis. Cureus. 2021 Feb 26;13(2):e13573. doi: 10.7759/cureus.13573. PMID: 33796422; PMCID: PMC8005326.
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Cureus. 2021 Feb 26;13(2):e13573. doi: 10.7759/cureus.13573.

Unrecognized Primary Hypothyroidism As a Possible Cause of Hyperreactio Luteinalis.

Cureus

Yash V Chauhan, Pradip P Dalwadi, Jugal V Gada, Premlata K Varthakavi, Nikhil Bhagwat

Affiliations

  1. Endocrinology, Topiwala National Medical College & Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, IND.

PMID: 33796422 PMCID: PMC8005326 DOI: 10.7759/cureus.13573

Abstract

Hyperreactio luteinalis (HRL) is characterised by benign enlargement of ovaries in pregnancy associated with hyperandrogenism. A 19-year-old primigravida presented with breathlessness, abdominal distension and vomiting in the thirteenth week of gestation. Abdominal examination revealed distension of abdomen disproportionate to the gestational age. Ultrasound was suggestive of bilaterally enlarged multicystic ovaries with a characteristic "spoke-wheel" pattern and a diagnosis of HRL was made. Laboratory investigations revealed primary hypothyroidism and elevated testosterone. She was initiated on levothyroxine therapy. Her respiratory distress worsened on the third day of admission for which she underwent emergency laparotomy with cyst aspiration. Thyroid function tests normalized within six weeks after the initiation of therapy and remained normal for the remainder of pregnancy. Serum testosterone levels returned to normal six weeks postpartum. The elevated thyroid-stimulating hormone levels could have contributed to development of HRL by cross-reacting with human chorionic gonadotropin and follicle-stimulating hormone receptors. Hyperandrogenism and ovarian enlargement regresses with levothyroxine therapy.

Copyright © 2021, Chauhan et al.

Keywords: fsh; hcg; hyperreactio luteinalis; hypothyroidism; pregnancy; spoke-wheel; tsh

Conflict of interest statement

The authors have declared that no competing interests exist.

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