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ovarian hyperstimulation syndrome
Etiology:
- iatrogenic complication of ovarian stimulation treatments for in vitro fertilization (most common)
- spontaneous
Pathology:
- increased capillary permeability resulting from release of vasoactive mediators from maturation of multiple ovarian follicles
- vascular endothelial growth factor is thought to be one of the mediators
- multiple serous & hemorrhagic follicular cysts lined by luteinized cells (hyperreactio luteinalis)
Genetics:
- autosomal recessive
- associated with defects in FSHR
Clinical manifestations:
- acute onset third spacing of fluid
- pleural effusions (generally bilateral)
- ascites
- peripheral edema
- hemoconcentration in severe cases
- vary from abdominal distension & discomfort to potentially life-threatening, massive ovarian enlargement & capillary leak with fluid sequestration
Laboratory:
- FSHR gene mutation
Management:
- supportive care, self-limited condition
General
endocrine disease
syndrome
Database Correlations
OMIM 608115
References
- UniProt :accession P23945
- Shmorgun D, Claman P
No-268-The Diagnosis and Management of Ovarian Hyperstimulation Syndrome.
J Obstet Gynaecol Can. 2017 Nov;39(11):e479-e486
PMID: 29080733
- Timmons D, Montrief T, Koyfman A, Long B.
Ovarian hyperstimulation syndrome: A review for emergency clinicians.
Am J Emerg Med. 2019 Aug;37(8):1577-1584. Epub 2019 May 7.
PMID: 31097257 Review.
- Kaiser UB
The Pathogenesis of the Ovarian Hyperstimulation Syndrome.
N Engl J Med. 2003, 349:8
PMID: 12930924
https://www.nejm.org/doi/pdf/10.1056/NEJMp038106