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NADİR BİR PLEVRAL EFÜZYON NEDENİ: OVER HİPERSTİMULASYON SENDROMU

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Abstract (2. Language): 
A 32 year old nulligravida with a 9 year history of infertility presented with dry cough and left pleuritic chest pain. She had undergone a transfer of embryos after an induction of ovulation with follicle stimulating hormone, gonadtropin releasing hormone and human chorionic gonadotropin two weeks ago. Two days after admission dyspnea appeared and chest x-ray demonstrated a moderate left pleural effusion. Spiral CT revealed left pleural effusion with otherwise normal findings. Pleural fluid was a lymphocytic exudate. Pleural biopsy revealed nonspesific inflammatory changes. Plasma estradiol and β-HCG concentrations were 3901 pg/ml and 172 IU/L respectively. Pelvic ultrasonography showed bilateral enlarged ovaries with numerous follicular cysts and ascites compatible with ovarian hyperstimulation syndrome (OHS). Pleural effusion may represent a diagnostic challenge for pulmonary clinician in OHS if the clinical presentation is equivocal.
Abstract (Original Language): 
Dokuz yıldır infertilite hikayesi olan 32 ya-şındaki nullipar bayan hasta öksürük ve sol plevral ağrı ile başvurdu. İki hafta önce hasta-ya FSH, GRH ve HCG ile ovulasyon indüksi-yonundan sonra embriyo transferi uygulanmış-tı. Başvurudan iki gün sonra dispne şikayeti gelişti ve akciğer grafisinde orta büyüklükte sol plevral efüzyon saptandı. Spiral BT’de sol plevral efüzyon dışında patolojik bulgu görül-medi. Plevral efüzyon lenfositik eksuda karak-terindeydi. Plevra biyopsisinin histopatolojik incelemesinde nonspesifik inflamatuar değişik-likler saptandı. Plazma estradiol ve β-HCG de-ğerleri sırasıyla 3901 pg/ml ve 172 IU/L olarak bulundu. Pelvis ultrasonografisinde over hiper-stimulasyon sendromu (OHS) ile uyumlu çok sayıda folliküler kist içeren bilateral büyümüş overler ve asit belirlendi. Klinik bulguların be-lirgin olmadığı OHS olgularındaki plevral efüzyon göğüs hastalıkları klinisyenleri için ta-nısal zorluk teşkil edebilir.
202-204

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References: 

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