MARKEDLY ELEVATED CYTOKINES IN PLEURAL EFFUSION DURING THE OVARIAN HYPERSTIMULATION SYNDROME - TRANSUDATE OR ASCITES

Objective: To study levels of proinflammatory cytokines in pleural flu id during the severe ovarian hyperstimulation syndrome (OHSS). Design: Case report. Setting: Tertiary academic medical center. Patient(s): A 35-year-old female with a B-year history of unexplained infertility o n menotropin therapy and 28 healthy normal controls. Intervention(s): Thoracentesis for severe pleural effusion and venipunctures. Main Outc ome Measure(s): Interleukin-1 beta (IL-beta), interleukin-6 (IL-6), an d tumor necrosis factor-alpha (TNF-alpha) levels were measured by ELIS A and compared between pleural effusion and serum from normal controls . Result(s): Pleural effusion IL-1 beta and IL-6 levels were higher th an serum. Interleukin-6 levels were elevated particularly in pleural e ffusion (1,961.89 pg/mL) compared with serum (3.9 +/- 0.41 pg/mL). Con clusion(s): Our results confirm the high cytokine levels observed in O HSS. Cytokines have been implicated in capillary permeability, extrava sation of fluid, oliguria, and shock. We have postulated that these me diators are released from the corpora lutea into the peritoneum and sy stemic circulation. Alternatively, the presence of high cytokine level s in pleural fluid maybe the result of diaphragmatic defects, which al low for the migration of ascites into the pleural space. (C) 1997 by A merican Society for Reproductive Medicine.