Increased angiotensin-converting enzyme activity in a patient with severe ovarian hyperstimulation syndrome.

ABSTRACT

OBJECTIVE: To assess plasma angiotensin-converting enzyme (ACE) activity in a patient with severe ovarian hyperstimulation syndrome (OHSS). DESIGN: Case report. SETTING: Private, university-affiliated infertility practice. PATIENT(S) A 35-year-old woman with OHSS. INTERVENTION(S) Clomiphene citrate induction of ovulation. MAIN OUTCOME MEASURE(S) Plasma ACE activity. RESULT(S) The patient had a brain stem infarction as a result of thrombosis caused by severe OHSS. Plasma ACE activity was significantly elevated and persisted long after resolution of the OHSS. CONCLUSION(S) Elevated ACE activity appears to have been associated with the development of OHSS in this patient. Further study of the ovarian renin-angiotensin system in the development of OHSS is warranted.