Myomatous Erythrocytosis Syndrome with Abnormally High Hemoglobin Level: A Case Report

Abstract

Myomatous Erythrocytosis Syndrome is a rare condition characterized by a myomatous uterus, erythrocytosis that spontaneously returns to normal red blood cells count after removal of the myomas. The etiology of this syndrome is still unknown but it has been observed that after myomectomy or hysterectomy the red blood cells count returns to normal. This case reports a 57 years old woman who presented with postmenopausal vaginal bleeding, a myomatous uterus of 16.2 x 16.1 x 22.6 cms, RBC 8.19 x 1012/L, Hemoglobin 21.5 g/dL, Hematocrit 67.1% and Erythropoietin of 23 mIU/mL. She was experiencing heavy postmenopausal bleeding and lower abdominal pain such that she consented to undergo a total abdominal hysterectomy with bilateral salpingo-ophorectomy. Two weeks after hysterectomy her hematology parameters reduced to normal levels, erythropoietin level was 8.2 mIU/mL. Histology results of the uterus showed leiomyomas, all the other symptoms resolved. It is suspected that erythropoietin from the myomas was responsible for the high RBCs, and the patient did not need any other treatment.