Original Articles: Case ReportsA severe case of ovarian hyperstimulation syndrome with liver dysfunction and malnutritionDavis, Andrew J.a; Pandher, Gurpreet K.b; Masson, Gordon M.b; Sheron, Nicka Author Information aDepartment of Gastroenterology and Hepatology, Southampton General Hospital, Southampton, UK, and bWessex Fertility Unit, Princess Anne Hospital, Southampton, UK Correspondence to Dr Nick Sheron, Department of Gastroenterology and Hepatology, Level D, South Block (811), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK Tel: +44 02380 795099; fax: +44 02380 794154; e-mail: [email protected] Received 18 September 2001 Revised 19 December 2001 Accepted 8 March 2002 European Journal of Gastroenterology & Hepatology: July 2002 - Volume 14 - Issue 7 - p 779-782 Buy Abstract Ovarian hyperstimulation syndrome (OHSS) is a potentially fatal condition associated with the use of ovulation-inducing drugs. We describe a 28-year-old woman who presented with ascites, oliguria and vomiting. Over 2 weeks, the combination of intractable vomiting, intravenous rehydration, paracentesis, hypercatabolism and proteinuria led to severe hypoalbuminaemia with gross oedema and progressively worsening liver function. The patient's albumin dropped to 9 g/l with liver function abnormalities peaking at: alanine aminotransferase, 462 IU/l; alkaline phosphatase, 706 IU/l; bilirubin, 26 μmol/l; and prothrombin time, 19 s. The judicious use of paracentesis and commencement of total parenteral nutrition coincided with a rapid clinical improvement. One month after discharge, the patient was asymptomatic with normal liver function. This case demonstrates the severity of malnutrition and liver dysfunction that can occur with severe OHSS. Increasing use of in-vitro fertilization techniques makes it mandatory for clinicians to be aware of the clinical features, complications and treatment of this condition, and we would suggest that patients with severe OHSS should be jointly managed by physicians and obstetricians. © 2002 Lippincott Williams & Wilkins, Inc.