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Severe ovarian hyperstimulation syndrome (OHSS) and icterus
F Nawroth1, J Heinrich, U Bruns
1Klinik für Gynäkologie und Geburtshilfe, Stralsund, Germany.
Human Reproduction (Oxford, England)
|November 1, 1996
Summary
Severe ovarian hyperstimulation syndrome (OHSS) can cause jaundice, a rare complication. This case highlights a patient with polycystic ovary syndrome (PCOS) who developed OHSS with cholestasis and jaundice after HMG treatment.
Area of Science:
- Reproductive Endocrinology
- Hepatology
- Clinical Case Reports
Background:
- Severe ovarian hyperstimulation syndrome (OHSS) is a known complication of ovulation induction therapies.
- While elevated aminotransferases are common in OHSS, a cholestatic presentation with hyperbilirubinemia and jaundice is rare.
Observation:
- A 33-year-old patient with polycystic ovary syndrome (PCOS) developed severe OHSS following human menopausal gonadotropin (HMG) stimulation.
- The patient presented with hemoconcentration, ascites, hydrothorax, elevated aminotransferases, hyperbilirubinemia, and jaundice.
Findings:
- The patient did not achieve pregnancy, and her OHSS symptoms, including jaundice and abnormal liver function tests, resolved spontaneously.
- The cholestatic features of OHSS in this case may be attributed to reactive cholestatic hepatosis secondary to hormonal changes from stimulation therapy.
Implications:
- This case underscores that cholestasis with jaundice can occur in severe OHSS, although infrequently.
- Clinicians should consider OHSS as a potential cause of cholestatic jaundice in patients undergoing ovulation induction, particularly those with PCOS.