An autopsy case of ovarian hyperstimulation syndrome with massive pulmonary edema and pleural effusion

Shuho Semba, Takuya Moriya, Emile M. Youssef, Hironobu Sasano

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50 Citations (Scopus)


Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of ovulation induction with exogenous gonadotropins, such as human menopausal gonadotropin and follicle-stimulating hormone. These hormones are considered to increase capillary permeability and cause third space fluid shift. We report an autopsy case of severe OHSS in a 28-year-old Japanese female. The patient developed bilateral chest pain and progressive dyspnea during the course of administration of human gonadotropins. Pleural effusion and hypouresis clinically disappeared 4 days after the onset of the symptoms, but the patient died suddenly of rapid respiratory insufficiency. Autopsy examination revealed massive pulmonary edema, intra-alveolar hemorrhage and pleural effusion without any evidence of pulmonary thromboembolism. Histopathological examination of the ovary demonstrated multiple well-developed follicle formations, consistent with OHSS. It is very important to recognize that massive pulmonary edema can occur in a patient with OHSS. To the best of our knowledge, this is the first autopsy report of a patient with severe OHSS.

Original languageEnglish
Pages (from-to)549-552
Number of pages4
JournalPathology international
Issue number7
Publication statusPublished - 2000


  • Human
  • Menopausal gonadotropin
  • Ovarian hyperstimulation syndrome
  • Pleural effusion
  • Polycystic ovary
  • Pulmonary edema

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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