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Nonobstructive Acute Renal Failure with a Large Solitary Fibroid
Rayan Elkattah1, Zineb Mashak1, Blakele Bakker1
1Department of Obstetrics and Gynecology, University of Tennessee Chattanooga College of Medicine, Chattanooga, TN 37403, USA.
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.
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