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J Korean Soc Emerg Med > Volume 16(4); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(4): 490-494.
A Case of Ovarian Hyperstimulation Syndrome with Left Hemiparesis
You Dong Sohn, Kyoung Soo Lim, Woo Joo Kim, Ji Yun Ahn, Bum Jin Oh, Won Kim
Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. kslim@amc.seoul.kr
ABSTRACT
Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of sterility treatment, such as pharmacological ovulation induction therapy. OHSS is clinically characterized by ovarian enlargement, abdominal distension, electrolyte imbalance, ascites, hypovolemia and hemoconcentration. But, the exact pathophysiology of OHSS is not fully understood. We believe that an increased capillary permeability leading to enhanced fluid extravasation seems to play a major pathogenic role, and also an imbalance in the rennin-angiotensin system is involved. Thromboembolic disease is usually considered to be a rare complication of OHSS. The common factors known to contribute to the risk of thrombosis are hemoconcentration, leukocytosis, thrombocytosis, and alteration in coagulation and fibrinolysis. But the majority of reported cases are venous in origin (75%), the remaining 25% are arterial thromboses. Especially in arterial thromboses, stroke is a rare event and potentially fatal complication. We report that a case of stroke combined with OHSS was received intravenous thrombolytics and recommend that emergency physicians keep in mind that one of possible causes of stroke in young woman who had been ovarian induction therapy is OHSS, and the timely intervention in OHSS with stroke is critical.
Key words: Ovarian hyperstimulation syndrome, Stroke, Thromboembolism
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