Korean Journal of Nephrology 1999;18(4):616-620.

급성 피질괴사가 동반된 자궁근종 1예 (A Case of Acute Cortical Necrosis Associated with Uterine Leiomyoma)

유영조, 오석중, 강경원, 김상목, 박찬현, 강종명, 최일영, 박한철 (Young Jo Yoo, Suk Joong Oh, Kyoung Won Kahng, Sang Mok Kim, Chan Hyun Park, Chong Myung Kang and Han Chul Park)

Abstract

Uterine myoma is the most common neoplasm of women and occurs in up to 20% of reproductive women. Leiomyoma may undergo secondary degeneration such as hyaline degeneration, sarcomatous change, and necrosis. This report presents a case of acute cortical necrosis(ACN) and disseminated intravascular coagulation caused by a uterine myoma necrosis. The uterine myoma of this patient was diagnosed and observed 10 months ago at other hospital. She complained of low abdominal pain with vaginal bleeding and anuria from the previous day. The laboratory findings were as follows:platelets 49,000/ mm3; prothrombin time 38%(normal control, 12 seconds); aPTT 41seconds(normal control, 26seconds); fibrinogen 81mg/dL; FDP<10μg/mL; BUN/sCr 23/ 2.9mg/dL. Acute cortical necrosis was diagnosed by radiologic grounds including abdominal computerized tomography(CT), which demonstrat ed decreased cortical contrast enhancement, normal medullary contrast enhancement, and preserved cortico-medullary differentiation. The patient was treated conservatively and underwent a CAPD operation later in her hospital course. On the 135th day after diagnosis, the ultrasonography, done in outpatient department, revealed the decreased size of both kidneys, respectively 7.5cm and 7.8cm. Urine output was about 800cc/day and the creatinine clearance of this patient was 9.2mL/ min.