From Ovarian Hyperstimulation to the Discovery of a Liver Nodule

TL;DR

A woman with ovarian hyperstimulation syndrome developed blood clots and later liver nodules, which are being monitored over time.

Contribution

This case report highlights a rare sequence of complications from ovarian hyperstimulation syndrome leading to thrombosis and liver nodules.

Findings

The patient developed severe OHSS followed by DVT in multiple veins.

Thrombophilia testing revealed four mutations.

Liver nodules were detected three years after delivery and are being monitored.

Abstract

Ovarian hyperstimulation syndrome (OHSS) is a complication of ovulation induction. Deep vein thrombosis (DVT) can occur as a consequence of this syndrome, but it is an infrequent event. The authors describe the case of a woman who became pregnant after ovulation induction and developed severe OHSS and, subsequently, DVT of the right brachiocephalic trunk, internal and external jugular veins, and right subclavian vein. Thrombophilia studies were positive, revealing the presence of four mutations. The pregnancy was bichorionic and biamniotic twins and, during the course of the pregnancy, she developed severe cholestasis. In the follow-up of this situation, she underwent abdominal ultrasound which revealed the presence of liver nodules. Three years after delivery, the patient remains anticoagulated and under surveillance of liver nodules by annual MRI.

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