Solsona Í, Peralta S, Barral Y, Fàbregues F, Giménez-Bonafé P. Unusual ovarian hyperstimulation syndrome presentation: Pleural effusion without ascites. A case report. World J Clin Cases 2025; 13(8): 100028 [DOI: 10.12998/wjcc.v13.i8.100028]
Corresponding Author of This Article
Pepita Giménez-Bonafé, BSc, MSc, PhD, Professor, Senior Research Fellow, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, Carrer Feixa Llarga, s/n, L'Hospitalet de Llobregat 08907, Barcelona, Spain. pgimenez@ub.edu
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2025; 13(8): 100028 Published online Mar 16, 2025. doi: 10.12998/wjcc.v13.i8.100028
Unusual ovarian hyperstimulation syndrome presentation: Pleural effusion without ascites. A case report
Íngrid Solsona, Sara Peralta, Yasmina Barral, Francisco Fàbregues, Pepita Giménez-Bonafé
Íngrid Solsona, Department of Physiological Sciences, Physiology Unit, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, Barcelona 08907, Catalonia, Spain
Sara Peralta, Yasmina Barral, Francisco Fàbregues, Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Faculty of Medicine, University of Barcelona, Barcelona 08036, Catalonia, Spain
Pepita Giménez-Bonafé, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat 08907, Barcelona, Spain
Author contributions: Solsona I and Peralta S collected the clinical information of the patient; Solsona I and Fàbregues F wrote the manuscript; Peralta S and Barral Y added information to the manuscript; Solsona I and Barral Y prepared the figures; Solsona I, Peralta S, Barral Y, Fàbregues F and Giménez-Bonafé P reviewed the manuscript; Giménez-Bonafé P supervised the data collection, organized the manuscript, corrected the English, and reviewed the final version of the manuscript.
Informed consent statement: The patient has given her consent for both the photos and her clinical information to be used anonymously for the publication of her case study.
Conflict-of-interest statement: The authors declare there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pepita Giménez-Bonafé, BSc, MSc, PhD, Professor, Senior Research Fellow, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, Carrer Feixa Llarga, s/n, L'Hospitalet de Llobregat 08907, Barcelona, Spain. pgimenez@ub.edu
Received: August 9, 2024 Revised: September 24, 2024 Accepted: October 16, 2024 Published online: March 16, 2025 Processing time: 116 Days and 17.8 Hours
Abstract
BACKGROUND
Ovarian hyperstimulation syndrome (OHSS) is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation. This case report highlights a unique manifestation of OHSS involving pleural effusion (PE) in a patient without identifiable risk factors.
CASE SUMMARY
A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization (IVF) cycle experienced dyspnea on the eleventh day of post oocyte retrieval. The diagnosis was severe OHSS with a unique manifestation of PE without ascites. Clinical management involved fluid balance and treatment with albumin, furosemide, thromboembolic prophylaxis, and thoracentesis. A continued drainage of the pleural cavity was performed. The patient had a favorable outcome, and a dichorionic diamniotic gestation passed without incident.
CONCLUSION
OHSS and its potential complications can include respiratory distress and PE, as well as thromboembolic disorders.
Core Tip: With the increasing use of assisted reproductive technologies, ovarian hyperstimulation syndrome (OHSS) should be a topic of continued research, and it is crucial to develop systematic guidelines for prevention, diagnosis, and management. The present case underscores the severe nature of OHSS and its potential complications, which can include respiratory distress and pleural effusion, as well as impact on the cardiac function. Furthermore, it highlights an atypical presentation of OHSS in a patient without identifiable risk factors, suggesting a need for reconsideration of both the criteria defining at-risk patients, and consequently identifying individuals who would benefit from preventive measures.
