title: An autopsy case of ovarian hyperstimulation syndrome with massive pulmonary edema and pleural effusion.
abstract: Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of ovulation induction with exogenous gonadotropins, such as human menopausal gonadotropin and follicle-stimulating hormone. These hormones are considered to increase capillary permeability and cause third space fluid shift. We report an autopsy case of severe OHSS in a 28-year-old Japanese female. The patient developed bilateral chest pain and progressive dyspnea during the course of administration of human gonadotropins. Pleural effusion and hypouresis clinically disappeared 4 days after the onset of the symptoms, but the patient died suddenly of rapid respiratory insufficiency. Autopsy examination revealed massive pulmonary edema, intra-alveolar hemorrhage and pleural effusion without any evidence of pulmonary thromboembolism. Histopathological examination of the ovary demonstrated multiple well-developed follicle formations, consistent with OHSS. It is very important to recognize that massive pulmonary edema can occur in a patient with OHSS. To the best of our knowledge, this is the first autopsy report of a patient with severe OHSS.
authors.affiliation: Department of Pathology and Tohoku University Hospital, Sendai, Japan. semba@mail.cc.tohuko.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Semba
authors.forename: T
authors.initials: T
authors.lastname: Moriya
authors.forename: E M
authors.initials: EM
authors.lastname: Youssef
authors.forename: H
authors.initials: H
authors.lastname: Sasano
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D005640:Follicle Stimulating Hormone / Q000494:pharmacology; D006062:Gonadotropins / Q000494:pharmacology; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications* / Q000473:pathology; D010053:Ovary / Q000187:drug effects / Q000473:pathology; D010062:Ovulation Induction / Q000009:adverse effects; D010996:Pleural Effusion / Q000209:etiology* / Q000473:pathology; D011654:Pulmonary Edema / Q000209:etiology* / Q000473:pathology
chemical_list: D006062:Gonadotropins; D005640:Follicle Stimulating Hormone