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1/2. Acute intermittent porphyria associated with ovarian stimulation. A case report.

    BACKGROUND: Induction of ovulation in the course of infertility treatment is increasingly commonplace in the 21st century. As a consequence, it can be expected that previously unrecognized complications of the procedure will be reported. CASE: A 36-year-old woman presented with severe pelvic pain and hyponatremia after ovarian stimulation with gonadotropins. After admission with a presumptive diagnosis of ovarian hyperstimulation syndrome, a further family history revealed acute intermittent porphyria. A 24-hour urine collection confirmed the diagnosis. CONCLUSION: Hormonal therapy for induction of ovulation in the course of infertility treatment may precipitate attacks of acute intermittent porphyria. A careful history must be undertaken prior to administration of such hormonal preparations.
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keywords = ovulation
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2/2. Initial presentation of undiagnosed acute intermittent porphyria as a rare complication of ovulation induction.

    OBJECTIVE: To discuss the diagnosis and management of acute intermittent porphyria following ovulation induction. DESIGN: Case report. SETTING: Academic IVF center. PATIENT(S): A patient with polycystic ovary syndrome and primary infertility undergoing ovulation induction with clomiphene citrate. INTERVENTION(S): Serial phlebotomy, IV fluid, inpatient observation. MAIN OUTCOME MEASURE(S): Condition at discharge. RESULT(S): The patient was diagnosed with severe hyponatremia caused by acute volume depletion and possible syndrome of inappropriate antidiuretic hormone secretion, secondary to acute intermittent prophyria, and was successfully managed with supportive measures. Neurovisceral symptoms resolved, and severe hyponatremia was corrected with IV saline solution without complications. CONCLUSION(S): Acute intermittent porphyrias are rare complications of ovulation induction, but should be considered in patients who develop unexplained hyponatremia or neurovisceral symptoms.
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ranking = 3.5
keywords = ovulation
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