A case report of spontaneous ovarian hyperstimulation syndrome and the long-term management of the endocrine disorder.

BACKGROUND: Spontaneous ovarian hyperstimulation syndrome (sOHSS) is a rarely reported clinical symptom of uncertain origin with the incidence of 0.2-1.2%. There is no report of the patients' follow-up situation after the remission of the clinical symptom and this is the first one. The aim of this study was to remind the medical staff of the necessity of long-term management.

CASE DESCRIPTION: We report a case of severe sOHSS with a normal 15 week gestation twin pregnancy in a 21-year-old primigravida who presented in our emergency room result from the 1 week's nausea and vomiting and progressively aggravated abdominal distension and pains for 3 days. The patient in our case had no significant precipitating factors and she had no previous outstanding medical history except that she had experienced acute glomerulonephritis when she was 9 years old. On ultrasound imaging, we found abnormally enlarged ovaries and massive ascites and moderate pleural fluid. A diagnosis of spontaneous ovarian hyperstimulation was made. The patient participated in followed-up visits for 1 year and experienced polycystic ovary syndrome (PCOS) and weight loss which up to 15kg after delivery.

CONCLUSIONS: Typically, although sOHSS is potentially life-threatening, its clinical detection is often delayed. A proactive strategy should be encouraged in the management of high-risk patients. The therapeutic schedule of mild-to-moderate sOHSS can focus on symptomatic relief and supportive treatment. Our case report elucidates the possible long-term effects of sOHSS and reminds us of the need for long-term management of those affected.