Hemolysis, Elevated Liver Enzyme Levels, and Low Platelet Levels (HELLP) Syndrome in Spontaneous Singleton Pregnancy Complicated by Hyperreactio Luteinalis: A Case Report

Abstract

Background: Hyperreactio Luteinalis (HL) is a rare condition during spontaneous pregnancy characterized by bilaterally, or in rare cases, unilaterally enlarged ovaries containing multiple self-limited theca lutein cysts, usually associated with high maternal serum levels of human chorionic gonadotropin (HCG) and hyperandrogenic state. Most of the patients require surgical intervention during their pregnancy because of ovarian torsion, preeclampsia, syndrome of hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP), or to rule out ovarian malignancy. However, we can avoid unnecessary surgical intervention with accurate diagnosis of HL by means of laboratory tests and magnetic resonance imaging (MRI). Case Report: A 27-year-old pregnant woman with gestational age of 27 weeks was admitted with labor pain and complicated with HELLP syndrome. In ultrasonography, bilateral and multiple ovarian cysts were seen. Conclusion: Reviewing this case suggests a relationship between HL and HELLP syndrome and may help to explain the underlying causes of preeclampsia; HL may be a predictor of preeclampsia and HELLP syndrome in pregnancy.

Keywords

• Hemolysisl
• elevated liver enzymes, and low platelets (HELLP) syndrome
• Hyperreactio luteinalis
• Preeclampsia