Myomatous erythrocytosis syndrome
| Myomatous erythrocytosis syndrome | |
|---|---|
| Synonyms | Uterine fibroid-associated erythrocytosis |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Polycythemia, menorrhagia, pelvic pain |
| Complications | Thromboembolism, hypertension |
| Onset | Typically in reproductive age women |
| Duration | Chronic |
| Types | N/A |
| Causes | Uterine fibroids |
| Risks | Obesity, nulliparity, African descent |
| Diagnosis | Blood test (elevated hemoglobin and hematocrit), pelvic ultrasound |
| Differential diagnosis | Polycythemia vera, secondary erythrocytosis |
| Prevention | N/A |
| Treatment | Surgical removal of fibroids, hysterectomy |
| Medication | Gonadotropin-releasing hormone agonists |
| Prognosis | Good with treatment |
| Frequency | Rare |
| Deaths | N/A |
Myomatous erythrocytosis syndrome is a rare medical condition characterized by the presence of uterine fibroids (myomas) and an associated increase in red blood cell mass, leading to erythrocytosis. This syndrome is notable for its unique combination of gynecological and hematological abnormalities.
Pathophysiology
The exact mechanism underlying myomatous erythrocytosis syndrome is not fully understood. However, it is believed that the uterine fibroids may produce erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. This overproduction of erythropoietin leads to erythrocytosis, which is characterized by an elevated hematocrit and hemoglobin levels.
Clinical Presentation
Patients with myomatous erythrocytosis syndrome typically present with symptoms related to both the uterine fibroids and the increased red blood cell mass. Common symptoms include:
- Menorrhagia (heavy menstrual bleeding)
- Pelvic pain
- Abdominal distension
- Fatigue
- Headaches
- Dizziness
Diagnosis
The diagnosis of myomatous erythrocytosis syndrome involves a combination of clinical evaluation, laboratory tests, and imaging studies. Key diagnostic steps include:
- Complete blood count (CBC) to assess hemoglobin and hematocrit levels
- Measurement of serum erythropoietin levels
- Pelvic ultrasound or MRI to identify and evaluate uterine fibroids
- Exclusion of other causes of erythrocytosis, such as polycythemia vera and chronic hypoxia
Treatment
The treatment of myomatous erythrocytosis syndrome focuses on managing both the uterine fibroids and the erythrocytosis. Treatment options may include:
- Myomectomy or hysterectomy to remove the uterine fibroids
- Medications to reduce erythropoietin production or red blood cell mass
- Phlebotomy to decrease hematocrit levels
Prognosis
The prognosis for patients with myomatous erythrocytosis syndrome varies depending on the severity of the condition and the effectiveness of the treatment. Surgical removal of the uterine fibroids often leads to a resolution of the erythrocytosis and improvement in symptoms.
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Contributors: Prab R. Tumpati, MD