伴有巨大孤立性子宫肌瘤的非梗阻性急性肾衰竭

Nonobstructive Acute Renal Failure with a Large Solitary Fibroid.

作者信息

Elkattah Rayan, Mashak Zineb, Bakker Blakele, Mohling Shanti, Yilmaz Ali, DePasquale Stephen, Boren Todd

机构信息

Department of Obstetrics and Gynecology, University of Tennessee Chattanooga College of Medicine, Chattanooga, TN 37403, USA.

Gülhane Military Medical Academy Haydarpasa Training Hospital, Department of Obstetrics and Gynecology, Selimiye Mahallesi, Tibbiye Caddesi, 34668 Istanbul, Turkey.

出版信息

Case Rep Obstet Gynecol. 2016;2016:4039890. doi: 10.1155/2016/4039890. Epub 2016 Jun 7.

DOI:10.1155/2016/4039890

PMID:27375910

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4914727/

Abstract

A 38-year-old African American woman presenting with acute abdominal pain and nonobstructive renal failure was found to have an enlarged fibroid uterus. A differential for sepsis was considered. Lab evaluation revealed an elevated creatinine and myoglobin level at 3.9 mg/dL and 2140 ng/mL, respectively. Ongoing hemodynamic instability mandated surgery for acute abdomen. A 25 cm fibroid uterus was extirpated through a total abdominal hysterectomy. Immediate improvement of acute nephropathy mirrored the postoperative decline in serum myoglobin levels. Myoglobinemia from a massive degenerating fibroid is associated with nonobstructive acute renal failure.

摘要

一名38岁的非裔美国女性因急性腹痛和非梗阻性肾衰竭就诊，发现有子宫肌瘤增大。考虑了败血症的鉴别诊断。实验室检查显示肌酐和肌红蛋白水平分别升高至3.9mg/dL和2140ng/mL。持续的血流动力学不稳定要求对急性腹部疾病进行手术。通过全腹子宫切除术切除了一个25厘米的子宫肌瘤。急性肾病的立即改善反映了术后血清肌红蛋白水平的下降。巨大变性肌瘤引起的肌红蛋白尿与非梗阻性急性肾衰竭有关。