Unusual ovarian hyperstimulation syndrome presentation: Pleural effusion without ascites. A case report

Table 1 Analytical evolution of the patient

Parameter	November 18	November 20	November 21	November 22	November 23	November 28	Units	Reference interval
Hemogram
Leukocytes	23.86	15.21	12.75	-	11.64	11.77	109/L	4.00-11.00
Red blood cells	5.25	4.98	4.75	-	4.35	3.61	1012/L	3.80-4.80
Hemoglobin	160	156	147	-	137	115	g/L	120-150
Hematocrit	0.500	0.470	0.440	-	0.410	0.340	L/L	0.360-0.460
Mean corpuscular volume	94.8	94.8	93.2	-	93.7	94.9	fl	80.0-100.0
Mean corpuscular hemoglobin	30.6	31.3	31.0	-	31.4	31.8	pg	26.7-33.3
Mean corpuscular hemoglobin concentration	322	330	333	-	335	335	g/L	310-350
Red cell distribution width	14.4	13.4	13.3	-	13.0	13.4	%	10.5-17.2
Hemoglobin distribution width	22.8	-	-	-	-	19.9	g/L	22.7-28.1
Platelets	431	432	374	-	371	380	109/L	130-400
Mean platelet volume	8.9	7.6	7.0	-	6.9	9.6	fl	6.2-11.0
Platelet distribution width	48.3	-	-	-	-	35.9	%	40.0-90.0
Automatic differential count
Neutrophils	79.5	77.9	76.6	-	82.3	70.8	%	45.0-75.0
Eosinophils	0.1	0.2	0.3	-	0.1	1.9	%	< 5.0
Basophils	0.7	0.2	0.2	-	0.2	0.4	%	< 2.0
Lymphocytes	14.1	14.8	16.0	-	11.1	20.7	%	17.0-55.0
Monocytes	4.6	5.8	5.5	-	5.2	5.3	%	2.0-10.0
Unidentified cell	1.0	1.2	1.5	-	1.0	0.9	%	< 4.0
Neutrophils	19.0	11.8	9.8	-	9.6	8.3	109/L	2.0-7.0
Eosinophils	0.0	0.0	0.0	-	0.0	0.2	109/L	< 0.5
Basophils	0.2	0.0	0.0	-	0.0	0.0	109/L	< 0.2
Lymphocytes	3.4	2.3	2.0	-	1.3	2.4	109/L	0.9-4.5
Monocytes	1.1	0.9	0.7	-	0.6	0.6	109/L	0.1-1.0
Unidentified cells ABS	0.2	0.2	0.2	-	0.1	0.1	109/L	< 4.0
Hemostasis
Prothrombin time	97.5	-	98.9	-	-	100.0	%	80.0-100.0
Prothrombin time (seconds)	12.2	-	11.8	-	-	12.0	sec	9.9-13.6
International normalized ratio	1.05	-	0.99	-	-	1.03
Prothrombin time ratio	1.03	-	1.01	-	-	1.02		0.85-1.15
Activated partial thromboplastin time	24.2	-	26.5	-	-	26.3	sec	23.5-32.5
Activated partial thromboplastin time ratio	0.9	-	1.0	-	-	1.0		0.8-1.2
Quantitative D-dimer	2550	1120	-	-	-	-	ng/mL	< 500
General biochemistry
C reactive protein	-	-	2.29	-	-	-	mg/dL	< 1.00
Glucose	87	92	94	-	115	66	mg/dL	65-110
Creatinine	0.84	0.86	0.92	-	0.93	0.68	mg/dL	0.30-1.30
Estimated glomerular filtration rate (Chronic kidney disease epidemiology collaboration)	88	85.33	78.65	-	77.63	>90	mL/min/1.73m²
Aspartate aminotransferase	19	31	-	-	51	37	U/L	5-40
Alanine aminotransferase	16	42	-	-	93	81	U/L	5-40
Gamma-glutamyl transferase	25	38	-	-	61	63	U/L	5-40
Total bilirubin	1.3	1.3	-	-	2.10	0.5	mg/dL	< 1.2
Direct bilirubin	0.4	0.4	-	-	0.90	-	mg/dL	< 0.6
Indirect bilirubin	0.9	0.9	-	-	1.2	-	mg/dL	< 0.6
Alkaline phosphatase	55	56	-	-	-	101	U/L	46-116
Lactate dehydrogenase	165	106	-	-	-	123	U/L	< 234
Albumin	45	50	-	-	60	46	g/L	34-48
Sodium	134	132	132	-	129	131	mEq/L	135-145
Potassium	4.4	4.0	3.6	-	3.8	4.5	mEq/L	3.5-5.5
Calcium	-	-	-	-	-	9.0	mEq/L	8.5-10.5
Recent urine sodium	21	-	-	-	-	-	mEq/L
Urine potassium	61.3	-	-	-	-	-	mEq/L
High-sensitivity troponin I (urgent)	-	-	-	12.5	-		ng/L	< 45.2
Gonadal axis
Beta human chorionic gonadotropin, serum	-	-	-	-	3392.70		mUI/mL	< 5.00
Arterial blood gas
pH, arterial blood	-	-	-	7.508	7.479			7.350-7.450
pCO2, arterial blood	-	-	-	27.0	30.9		mmHg	35.0-45.0
pO2, arterial blood	-	-	-	59.6	103.2		mmHg	75.0-100.0
Actual bicarbonate, arterial blood	-	-	-	21.0	22.4		mmol/L	21.0-26.0
Total CO2, arterial blood	-	-	-	21.8	23.4		mmol/L	23.0-29.0
Base excess, arterial blood	-	-	-	-0.80	-0.20		mmol/L	-3.00-3.00
Hematocrit, arterial blood	-	-	-	39.0	-		%	36.0-51.0
Hemoglobin, arterial blood	-	-	-	13.1	-		g/dL	12.0-17.0
Carboxyhemoglobin, arterial blood	-	-	-	0.90	-		%	< 4.00
Methemoglobin, arterial blood	-	-	-	0.3	-		%	< 1.5
Ionized calcium, arterial blood	-	-	-	1.08	-		mmol/L	1.03-1.23
Sodium, arterial blood	-	-	-	126	-		mmol/L	135-145
Potassium, arterial blood	-	-	-	4.0	-		mmol/L	3.5-5.5
Chloride, arterial blood	-	-	-	94	-		mmol/L	98-107
Glucose, arterial blood	-	-	-	103	-		mg/dL	65-110
Lactate, arterial blood	-	-	-	12.2	-		mg/dL	5.0-20.0
Bilirubin, arterial blood	-	-	-	< 2	-		mg/dL
Arterial standard bicarbonate	-	-	-	-	24.3		mmol/L	21.0-28.0
Oxygen Hb arterial saturation	-	-	-	-	98.3		%	95.0-99.0
Ionized calcium; arterial blood	-	-	-	-	1.11		mmol/L	1.03-1.23
Arterial oxyhemoglobin fraction	-	-	-	-	97.2		%	> 95.0