Two cases of myomectomy complicated by intravascular hemolysis and renal failure: disseminated intravascular coagulation or hemolytic uremic syndrome?

Is there an Association between Thrombosis and Fibroids? A single centre experience and literature review

“…However, mechanical pressure is not the only the factor related to VTE associated with fibroids as evidenced by our and other centres' experience [3]. Invasion of pelvic veins by fibroid tissue causing intravascular leiomyomatosis could lead to thrombosis due to such mechanisms like inflammation, release of tissue factor, collagen and thrombospondin 1 and blood flow obstruction [4][5][6]. Thrombosis could also be secondary to menorrhagia and resultant iron deficiency anaemia [7].…”

Disseminated Intravascular Coagulation after Myomectomy: A Case Report and Review of Literature

“…DIC has been reported as one of the more common hematological complication following myomectomy apart from rarer condition, such as microangiopathic hemolytic anemia, which can cause a diagnostic dilemma. 4,5 The other differential diagnosis in such scenario is thrombotic thrombocytopenic purpura (TTP).…”

“…The uterus is known to be rich in tissue factor and extensive handling of fibroid could lead to massive release of such tissue factors, which when combined with other factors (surgery, administration of colloids and sepsis) could be ideal setting for DIC to set in. 4,6,7 No single coagulation parameter is diagnostic of DIC. Thrombocytopenia or a progressive drop in platelet count is a sensitive test for DIC.…”

“…3 There are case reports of patients developing hemolytic uremic syndrome and renal failure following uncomplicated myomectomy, which due to similar clinical presentation, could possibly present a diagnostic dilemma for the clinicians. 4 We present a rare case of DIC following myomectomy which was managed conservatively accompanied by a review of literature.…”

Postsurgical thrombotic microangiopathy: Case series and review of the literature

“…Cardiovascular surgeries were the most common procedure provoking TMA with coronary artery bypass grafts (CABG) [14][15][16][17][18] or a combination of CABG with another vascular procedure being the second most common. 14,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Of TMAs occurring after abdominal surgery, 26,[31][32][33][34][35][36][37] bowel resection accounted for the most common preceding procedure (n = 6). 17,33,[38][39][40][41][42] In addition, five patients developed TMA following orthopedic procedures.…”