Here is a case: someone with elevated serum creatinine, hyponatermia, marked edema and hypoalbuminemia --> 6 weeks into pregancy induce by in vitro fertilization.
We will pause here to recognize British researcher Robert Edwards who was just awarded the 2010 Nobel Prize in Medicine...
Ovarian Hyperstimulation Syndrome(OHSS) typically presents as volume overload and elevated serum creatinine early in the course of IVF. Hormonal therapy (appropriately) stimulates the ovaries, but occasionaly "hyper"-stimulated ovaries enlarge, become cycstic and large fluid shifts can occur in a capillary-leak like syndrome. It is believed that Vascular Endothelial Growth Factor plays a role by increasing sensitivity to nitric oxide and promoting neoangiogenesis.
Cases range from mild to life-threatening and are graded in severity from 1-3. Mild cases are treated with observation and discontinuation of hormonal therapy, whereas severe cases can have marked electrolyte disorders (hyponatremia, hyperkalemia), severe ascites, pericarial/pleural effusions and thromboembolic phenomenon from hemoconcentration.
- ► 2020 (21)
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- Nephsap review: AKI and ICU Nephrology
- Minimal Change Disease
- IN THE NEWS- CALMAG TRIAL
- TOPIC DISCUSSION: Management of DKA in hemodialysi...
- Nephrology Fellows do better with online training!
- IN THE NEWS- Barbershop BP management is better th...
- Outcomes of kidney transplantation from HCV positi...
- IN THE NEWS- Permeability Factor and FSGS
- Salivary Prograf levels
- U 002 Nierentransplantation / kidney transplant
- TOPIC DISCUSSION: Green Urine
- FGF-23 and PTH and Bone Disease post transplant
- IN THE NEWS- Bilirubin might be protective
- Aspergilloma in the transplant kidney
- Racial Disparities in CKD, a presentation
- CONSULT ROUNDS: Page Kidney
- Renal Fellow Network: Pancreas transplant pearls
- TOPIC DISCUSSION: Different ARBS
- TOPIC DISCUSSION: Urinary Diversions
- Wait list and desensitization?
- CLINICAL CASE 27, ANSWERS and SUMMARY
- Sirolimus and Male Fertility
- IN THE NEWS:- Tiger on Dialysis
- IN THE NEWS:- Cardiorenal syndrome or renocardiac ...
- NEJM Case
- CONSULT ROUNDS: renal disease
- TOPIC DISCUSSION: Chronic Hyponatremia
- Quiz 7 Answers
- New Transplant Information website
- CONSULT ROUNDS: Free water excretion
- TOPIC DISCUSSION: SECONDARY VS PRIMARY FSGS
- TOPIC DISCUSSION: Maintenance of Metabolic Alkalosis
- REJECTION and TOLERANCE
- KIDNEY WEBSITES IN my languages!
- Renal Fellow Network: Key to angiotensin formation...
- JOURNAL CLUB: AASK TRIAL 2010
- TOPIC DISCUSSION: An uncommon consult:-OHSS!
- IN THE NEWS- Nephrology Workfore
- Basic concepts in Immunology
- Role Playing exercise in Transplant Education
- TOPIC DISCUSSION
- CLINICAL CASE 26 , ANSWER and SUMMARY
- ▼ October (42)