Immunoglobulin Treatment in Severe Ovarian Hyperstimulation Syndrome

Gemma Grau Gómez; Oriol Giménez Campanario; Nuria Pons Serra; Mireia Cairó Llobell; Pedro Almagro Mena

doi:10.12890/2019_001253

Immunoglobulin Treatment in Severe Ovarian Hyperstimulation Syndrome

Eur J Case Rep Intern Med. 2019 Oct 2;6(10):001253. doi: 10.12890/2019_001253. eCollection 2019.

Authors

Gemma Grau Gómez¹, Oriol Giménez Campanario², Nuria Pons Serra², Mireia Cairó Llobell¹, Pedro Almagro Mena¹

Affiliations

¹ Department of Internal Medicine, Fundació Mútua de Terrassa, Terrassa, Spain.
² Department of Obstetrics and Gynecology, Fundació Mútua de Terrassa, Terrassa, Spain.

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.

Learning points: OHSS is an infrequent yet serious complication of assisted reproductive treatment that involves increased capillary permeability.In severe refractory cases, immunoglobulins may be a useful and safe treatment to reverse this syndrome.

Keywords: Severe ovarian hyperstimulation syndrome; immunoglobulins.