Features of the Renin-angiotensin system in ascites and pleural effusion during severe ovarian hyperstimulation syndrome.
OBJECTIVE
The purpose of this work was to investigate the ovarian renin-angiotensin system (RAS) during severe ovarian hyperstimulation syndrome (OHSS) with ascites and pleural effusion.


METHODS
Two patients who developed severe OHSS after ovarian stimulation for in vitro fertilization were investigated. Both patients presented ascites and pleural effusion. Blood, ascites, and pleural fluid were simultaneously sampled during therapeutic paracentesis and thoracocentesis. Renin activity, active renin, prorenin, and angiotensin II immunoreactivity (Ang II-ir) were measured simultaneously in plasma, ascites, and pleural fluid.


RESULTS
Prorenin, renin activity, active renin, and Ang II-ir levels were much higher than normal plasmatic laboratory norms in the three compartments. Prorenin and Ang II-ir levels were the highest in the ascites, while they were in the same range in the pleural fluid and in the plasma.


CONCLUSIONS
The present findings provide additional evidence for the ovarian origin of the prorenin and Ang II-ir in the ascites of severe OHSS.
Delbaere
A
A
Department of Gynecology and Obstetrics, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Bergmann
P J
PJ
Englert
Y
Y
D000328:Adult; D000804:Angiotensin II / Q000032:analysis / Q000097:blood; D001202:Ascitic Fluid / Q000737:chemistry*; D004792:Enzyme Precursors / Q000032:analysis / Q000097:blood; D005260:Female; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000378:metabolism*; D010062:Ovulation Induction / Q000009:adverse effects; D010996:Pleural Effusion / Q000737:chemistry*; D012083:Renin / Q000032:analysis / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology*
D004792:Enzyme Precursors; D000804:Angiotensin II; D012083:Renin