In addition, a complete blood cell count revealed hemoconcentration
, with a white-cell count of 16300 cell/[micro]L, hemoglobin level of 25.7 g/L, and platelet count of 614000 cell/[micro]L.
1- Indications for admission: Patients with severe OHSS should be admitted to the hospital for treatment if they suffer from severe abdominal pain, nausea and vomiting, hemoconcentration
, severe ascites, profound oliguria or anuria, decrease in blood pressure, tachypnea or dyspnea, light-headedness or syncope, electrolyte disturbances (hyponatremia and hyperkalemia), or abnormal liver function test.
One important limitation was the fact that the diagnosis of SIADH and CSWS was made on the basis of clinical suspicion and not on paraclinical testing, because the majority of patients were critically ill and criteria such as hemoconcentration
, blood sugar, fluid balance, and changes in renal function tests may vary significantly due to multiple causes, increasing the difficulty of the diagnosis.
(18) Therefore, the elevation in aminotransferase levels during the night would not be due to hemoconcentration
but to other factors (probably due to OSA with hypoxemia), and there were significant correlations between serum aminotransferase levels in the morning and increases from afternoon values to those the next morning (Fig.
Urinalysis is positive for glucose; complete blood count is normal other than showing a slight hemoconcentration
. RH is found to be dehydrated.
As a remediation, we have evaluated hematocrit and blood urea nitrogen, which often were used as the markers of hemoconcentration
, as confounding factors of hypoalbuminemia in our multivariate logistic regression analysis.
Upon admission, the CBC was reviewed showing hemoconcentration
(Hb: 14.2 g/dL, Ht: 45%), thrombocytopenia (27,000/mm3), and leukocytosis (17,800/mm3) with neutrophilia (66.6%).
There was no evidence of hemoconcentration
(hemoglobin, 11.7 g/dL; hematocrit, 34.7%; Na+, 135 mEq/L; and K+, 4.2 mEq/L).
In acute poisoning, hemoconcentration
may be indicated by rise in red blood cell count and hematocrit as with other acid and acid-like corrosives .
Ovaries enlarged 5-12 cm Moderate 3 Criteria of mild OHSS + echographic signs of ascites Severe 4 Criteria of moderate OHSS + clinical signs of ascites and/or hydrothorax and respiratory distress 5 All of the above + changes in blood volume and viscosity, hemoconcentration
, coagulation disorders and decreased renal output and function 6 Life-threatening form
Idiopathic hypoalbuminemia is different from systemic capillary leak syndrome (SCLS) which presents with recurrent acute episodes of vascular leakage manifesting as severe hypotension, hypoalbuminemia, hemoconcentration
, and generalized edema.4
The criteria for DHF included (1) continuous high grade fever lasting 2 to 7 days; (2) hemorrhagic tendency as shown by a positive tourniquet test, petechiae, or epistaxis; (3) platelet counts <100,000/cumm; and (4) evidence of plasma leakage manifested by hemoconcentration
(an increase in hematocrit 20% above the average for age, sex, and population), pleural effusion, and ascites.