Document Detail


Spontaneous ovarian hyperstimulation syndrome and pituitary adenoma: incidental pregnancy triggers a catastrophic event.
MedLine Citation:
PMID:  19356755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report a rare case of spontaneous ovarian hyperstimulation syndrome (OHSS) associated with spontaneous pregnancy and a FSH-secreting pituitary adenoma. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 32-year-old woman with spontaneous OHSS. INTERVENTION(S): Transsphenoidal resection of the tumor. MAIN OUTCOME MEASURE(S): Regression of the symptoms of OHSS and hyperestrogenemia. RESULT(S): At presentation, the patient's ovaries were markedly enlarged and massive ascites was seen. Her serum E(2) level was markedly elevated, but her LH level was low, and FSH was within the normal range. In addition, her TSH level was normal, and hCG was appropriate for the date of pregnancy. Subsequently, the patient developed massive thrombophlebitis in her right internal jugular and subclavian veins. Termination of the pregnancy ameliorated the accumulation of ascites, but ovarian enlargement and hyperestrogenemia persisted. No mutations of the FSH receptor, LH receptor, or aromatase genes were detected, but magnetic resonance imaging (MRI) of the head revealed a pituitary adenoma. After transsphenoidal resection of the tumor, the patient got better. CONCLUSION(S): A gonadotropin-secreting adenoma caused ovarian hyperstimulation (ovarian enlargement and hyperestrogenemia). In addition, spontaneous pregnancy and intrinsic hCG increased vascular permeability, which complicated the patient's disease.
Authors:
Tsuyoshi Baba; Toshiaki Endo; Yoshimitsu Kitajima; Hirofumi Kamiya; Osamu Moriwaka; Tsuyoshi Saito
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-08
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-29     Completed Date:  2009-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390.e1-3     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido, Japan. tbaba@sapmed.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications*,  pathology,  secretion,  surgery
Adult
Anticoagulants / therapeutic use
Dilatation and Curettage
Estrogens / blood
Female
Follicle Stimulating Hormone / secretion
Humans
Ovarian Hyperstimulation Syndrome / complications*,  therapy
Paracentesis
Pituitary Neoplasms / complications*,  pathology,  secretion,  surgery
Pregnancy
Pregnancy Complications / etiology*
Thrombosis / complications,  drug therapy
Ultrasonography, Prenatal / adverse effects
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Estrogens; 9002-68-0/Follicle Stimulating Hormone

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