Immunoglobulin Treatment in Severe Ovarian Hyperstimulation Syndrome

  • Gemma Grau Department of Internal Medicine, Fundació Mútua de Terrassa, Terrassa, Spain
  • Oriol Giménez Department of Obstetrics and Gynecology, Fundació Mútua de Terrassa, Terrassa, Spain
  • Nuria Pons Department of Obstetrics and Gynecology, Fundació Mútua de Terrassa, Terrassa, Spain
  • Mireia Cairó Department of Internal Medicine, Fundació Mútua de Terrassa, Terrassa, Spain
  • Pedro Almagro Department of Internal Medicine, Fundació Mútua de Terrassa, Terrassa, Spain

Keywords

Severe ovarian hyperstimulation syndrome, immunoglobulins

Abstract

A 32-year-old woman undergoing an in vitro fertilization program was admitted to our hospital with the diagnosis of severe ovarian hyperstimulation syndrome (OHSS). Transvaginal ultrasonography showed two gestational sacs. Treatment with fluid restriction, serum albumin and intravenous furosemide was started, and repeated thoracentesis and paracenteses were performed. In the absence of clinical improvement, the patient was transferred to the intensive care unit and a therapeutic abortion was suggested. Due to the similarities between OHSS and idiopathic systemic capillary leak syndrome, we offered the patient compassionate treatment with intravenous immunoglobulins.
After administration, the patient showed rapid improvement and we were able to suspend intravenous furosemide and serum albumin. She was discharged, and pregnancy has continued normally to date.

References

  • Selter J, Wen T, Palmerola KL, Friedman AM, Williams Z, Forman EJ. Life-threatening complications among women with severe ovarian hyperstimulation syndrome. Am J Obstet Gynecol 2019;220(6):575.e1–575.e11.

  • Siddall E, Khatri M, Radhakrishnan J. Capillary leak syndrome: etiologies, pathophysiology, and management. Kidney Int 2017;92:37–46.

  • Xie Z, Ghosh CC, Parikh SM, Druey KM. Mechanistic classification of the systemic capillary leak syndrome: Clarkson disease. Am J Respir Crit Care Med 2014;189(9):1145–1147.

  • Pineton de Chambrun M, Gousseff M, Mauhin W, et al. Intravenous immunoglobulins improve survival in monoclonal gammopathy-associated systemic capillary-leak syndrome. Am J Med 2017;130(10):1219.e19–1219.e27.

  • Almagro P, Martí JM, Garcia Pascual L, Rodriguez-Carballeira M. Successful treatment of systemic capillary leak syndrome with intravenous immunoglobulins. Rev Clin Esp 2012;212(4):218–219.
  • Published: 2019-10-02

    Issue: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    Grau, G., Giménez, O., Pons, N., Cairó, M., & Almagro, P. (2019). Immunoglobulin Treatment in Severe Ovarian Hyperstimulation Syndrome. European Journal of Case Reports in Internal Medicine, 2. https://doi.org/https://doi.org/10.12890/2019_001253