losartan-potassium and Leiomyoma

Topics: Erythropoietin; Female; Humans; Hysterectomy; Leiomyoma; Middle Aged; Paraneoplastic Endocrine Syndromes; Polycythemia; Uterine Neoplasms

Topics: Adenocarcinoma; Adrenal Gland Neoplasms; Animals; Brain Neoplasms; Carcinoma; Carcinoma, Hepatocellular; Cell Transformation, Neoplastic; Cells, Cultured; Cricetinae; Cysts; Erythropoietin; Esophageal Neoplasms; Female; Growth Substances; Haplorhini; Humans; In Vitro Techniques; Kidney Neoplasms; Leiomyoma; Leukemia; Leukemia, Experimental; Liver Neoplasms; Lymphoma; Male; Mice; Neoplasm Metastasis; Neoplasm Transplantation; Pheochromocytoma; Polycythemia; Rats; Sarcoma, Experimental; Skin Neoplasms; Time Factors; Wilms Tumor

Topics: Adolescent; Adult; Aged; Animals; Blood Pressure; Cerebellar Neoplasms; Erythrocyte Count; Erythropoietin; Female; Humans; Hydronephrosis; Kidney; Kidney Diseases, Cystic; Kidney Neoplasms; Leiomyoma; Leukocytes; Liver Neoplasms; Male; Middle Aged; Pheochromocytoma; Polycythemia; Serum Globulins; Uterine Neoplasms

The purpose of this study was to investigate the efficacy of preoperative recombinant human erythropoietin (rHuEPO) treatment in a group of mildly anemic women.. This randomized controlled study included 50 healthy, mildly anemic women who underwent total hysterectomy for leiomyomas. The study group (Group A) included 23 women who received rHuEPO 600 U/kg once weekly for three weeks, plus iron supplementation. The control group (Group B) included 27 women who received only iron supplementation. Blood samples were obtained on days -14, -7, 0, +3, +7 and +14.. An increase in preoperative mean hemoglobin concentration was noted in both groups; however, the increase was significantly higher in Group A throughout the study period. Mean reticulocyte count was also significantly higher in this group, whereas mean ferritin level was significantly lower. No postoperative transfusion was needed in Group A, whereas five women were transfused in Group B.. Rapid and persistent improvement of hematologic parameters makes the use of rHuEPO for preoperative treatment of mildly anemic women with benign uterine pathology a very interesting approach.

Topics: Adult; Anemia; Dose-Response Relationship, Drug; Drug Administration Schedule; Erythropoietin; Female; Follow-Up Studies; Hemoglobins; Humans; Hysterectomy; Leiomyoma; Middle Aged; Preoperative Care; Recombinant Proteins; Reference Values; Reticulocyte Count; Severity of Illness Index; Treatment Outcome; Uterine Neoplasms

To compare the effects of preoperative treatment with recombinant human erythropoietin (EPO) and iron with iron only on hemoglobin levels (Hb) in anemic women prior to hysterectomy.. The study was an open-labelled randomized parallel study. Fifteen women scheduled for hysterectomy due to uterine myoma were given oral iron and EPO (NeoRecormon) 4 weeks prior to surgery (group I) and 16 women were given oral iron only (group II).. Group I showed a significantly greater increase in mean Hb during the pre-surgery study period compared with group II (p=0.007). Two weeks postoperatively, however, there was no significant difference in mean Hb between the two groups.. We found that a significantly greater increase in Hb was achieved with iron in combination with EPO, although in most cases iron only seemed to be as efficacious as iron+EPO in correcting anemia in myoma patients pre-operatively.

Topics: Administration, Oral; Adult; Aged; Analysis of Variance; Anemia; Chi-Square Distribution; Drug Therapy, Combination; Erythropoietin; Female; Follow-Up Studies; Hemoglobins; Humans; Hysterectomy; Iron Compounds; Leiomyoma; Length of Stay; Middle Aged; Postoperative Period; Preoperative Care; Probability; Prospective Studies; Recombinant Proteins; Statistics, Nonparametric; Treatment Outcome; Uterine Neoplasms

Gonadotropin-releasing hormone agonists are used to treat premenopausal uterine leiomyomas; however, leiomyoma volume reduction is not always achieved. The reduction rate after this treatment varies for each leiomyoma, even in the same patient. Therefore, an effective method for predicting uterine leiomyoma volume reduction is required to reduce the adverse hypoestrogenic effects and drug-related economic burden related to gonadotropin-releasing hormone agonists.. This study aimed to determine the predictive use of MED12 mutations for evaluating the effect of gonadotropin-releasing hormone agonist treatment concerning reducing uterine leiomyoma volume and to predict the MED12 mutation status based on the findings of magnetic resonance imaging performed before treatment.. MED12 exon 2 mutation and erythropoietin expression in uterine leiomyomas were evaluated concerning volume reduction, as measured using magnetic resonance imaging. We developed a system for classifying leiomyomas according to T2-weighted magnetic resonance imaging signals to noninvasively predict the presence or absence of MED12 mutations in leiomyomas. Leiomyoma samples (>5 cm) were obtained from 168 patients during surgery (hysterectomy or myomectomy) between 2005 and 2021 at Yokohama City University Hospital. To analyze the rate of leiomyoma volume reduction, 41 patients had been preoperatively administered the gonadotropin-releasing hormone agonist (leuprorelin acetate 3.75 mg, monthly subcutaneous injection) for 3 months; magnetic resonance imaging was performed before and after treatment without contrast material.. Patients with MED12 exon 2 mutations had smaller volume reduction after treatment with the gonadotropin-releasing hormone agonist (P<.001, Mann-Whitney U test) and displayed lower signal intensity on T2-weighted images than those with leiomyomas expressing wild-type MED12 exon 2. The newly proposed magnetic resonance imaging-based classification system showed that MED12 exon 2 mutations were more frequent in the low-signal group than in the high-signal group, with nearly equal proportions of mutated and wild-type MED12 exon 2 leiomyomas noted in the intermediate group. The low-signal group had significantly lower erythropoietin expression levels than the high-signal group (P<.001, Kruskal-Wallis test with the Dunn posthoc analysis).. MED12 mutation status can be a candidate marker for predicting the effect of gonadotropin-releasing hormone agonists on uterine leiomyoma reduction. Magnetic resonance imaging findings can be used to determine MED12 mutation status as a noninvasive strategy to select patients who will most likely benefit from gonadotropin-releasing hormone agonist treatment.

Topics: Erythropoietin; Female; Gonadotropin-Releasing Hormone; Humans; Leiomyoma; Leuprolide; Mediator Complex; Mutation; Uterine Neoplasms

We report the case of a 50-year-old woman with severe erythrocytosis and uterine leiomyoma. The suspicion of myomatous erythrocytosis syndrome was supported by erythropoietin level higher than expected. After the supravaginal hysterectomy, the patient's red cell parameters normalized and the erythropoietin level markedly decreased. The authors are discussing the physiology of uterine erythropoietin, the evaluation and differential diagnostic value of erythropoietin investigations. Orv Hetil. 2022; 163(52): 2088-2092.. A szerzők egy 50 éves myomás nőbeteget erythrocytosisa miatt vizsgáltak. A két lelet kapcsolatát, a myomás erythrocytosis gyanúját a vártnál magasabb erythropoetinszint erősítette, majd a supravaginalis hysterectomia a diagnózist igazolta. A műtét után a beteg vérképe normalizálódott, és szérum-erythropoetinszintje jelentősen csökkent. Az eset kapcsán a szerzők az uterusban termelődő erythropoetin fiziológiájáról, a szérum-erythropoetinszintek értékeléséről és differenciáldiagnosztikai hasznáról írnak. Orv Hetil. 2022; 163(52): 2088–2092.

Topics: Erythropoietin; Female; Humans; Hysterectomy; Leiomyoma; Middle Aged; Polycythemia; Syndrome; Uterine Neoplasms

Topics: Erythropoietin; Humans; Leiomyoma; Mediator Complex; Mutation; RNA; Uterine Neoplasms

To determine factors that impact erythropoietin (EPO) production in leiomyomas. We have previously implicated EPO production in promoting the growth of some leiomyomas.. The relationship between EPO messenger RNA (mRNA) expression and MED12 gene mutations or mRNA expression levels of high-mobility group AT-hook (HMGA) 1 and HMGA2 were analyzed. Effects of 10. Graduate school of medicine.. Patients with leiomyoma.. We used tissue samples and clinical data of 108 patients with leiomyomas to analyze the relation between EPO mRNA expression and MED12 mutation. Tissue samples from another 10 patients with leiomyomas were collected for in vitro experimentation using primary cultures of leiomyoma and myometrial cells.. Relations between EPO mRNA expression, MED12 exon 2 mutation, and HMGA1/HMGA2 mRNA expression levels in leiomyoma samplings, in addition to effects of estrogen (E) on EPO mRNA expression in cultures of leiomyoma cells.. The EPO mRNA level was threefold higher in leiomyomas with wild-type (vs. mutated) MED12 genes. There was no correlation between EPO and HMGA1 or HMGA2 mRNA expression levels. In wild-type MED12 leiomyomas only, E. The EPO mRNA expression increased significantly after E

Topics: Adult; Biomarkers, Tumor; Erythropoietin; Estradiol; Female; Gene Expression Regulation, Neoplastic; Humans; Leiomyoma; Mediator Complex; Middle Aged; Mutation; RNA, Messenger; Tumor Burden; Tumor Cells, Cultured; Uterine Neoplasms

Myomatous erythrocytosis syndrome is a rare complication of uterine leiomyoma caused by erythropoietin (EPO) that is produced by tumor cells. We assessed the EPO expression in leiomyomas and investigated the effects of EPO on the tumor growth.. Tissue samples were collected from 114 patients with uterine leiomyomas who underwent myomectomy or hysterectomy in Yokohama City University Hospital. From 17 patients, the corresponding normal myometrium was also collected. All samples were analyzed for EPO messenger RNA (mRNA) expression by real-time reverse transcription-polymerase chain reaction. EPO protein expression was determined by an enzyme-linked immunosorbent assay. The relationships between EPO expression and clinicopathological features were retrospectively analyzed using the patients' charts. Blood vessel density and maturity were assessed using hematoxylin-eosin staining and CD34 immunohistochemistry.. EPO mRNA expression was detected in 108 of 114, or 95%, of the leiomyomas. The mean EPO mRNA expression in the leiomyoma was higher than the corresponding normal myometrium (3836 ± 4122 vs 1455 ± 2141; P = .025 by Wilcoxon rank test). The EPO mRNA expression in the leiomyomas varied extensively among samples, ranging from undetectable levels to 18-fold above the mean EPO mRNA of normal myometrium. EPO protein production was observed concomitant with mRNA expression. A positive correlation of leiomyoma size and EPO mRNA expression was shown by Spearman rank correlation coefficient (ρ = 0.294; P = .001), suggesting the involvement of EPO in leiomyoma growth. The blood vessel maturity was also significantly increased in EPO-producing leiomyomas (high vessel maturity in high vs low EPO group: 67% vs 20%; P = .013 by Fisher exact test).. This report demonstrates that EPO is produced in most of conventional leiomyomas and supports a model in which EPO accelerates tumor growth, possibly by inducing vessel maturity. Our study suggests one possible mechanism by which some uterine leiomyomas reach a large size, and the understanding of EPO expression patterns in these tumors may be useful for management of the patients with leiomyomas.

Topics: Adult; Aged; Antigens, CD34; Blood Vessels; Enzyme-Linked Immunosorbent Assay; Erythropoietin; Female; Humans; Immunohistochemistry; Leiomyoma; Middle Aged; Myometrium; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Uterine Neoplasms

The study sample included 170 patients with gynecological diseases, 5 patients with persistent anemia due to systematic blood disorder, 14 healthy patients. The decrease of hemoglobin level lower than 110 g/l is established in 25.7% gynecologic patients and most frequently in those with hysteromyoma. The study revealed that anemia developed due to the female reproductive system disorders and independently of clinically marked loss of blood is an. The biologic characteristic of anemia is the decrease of erythrocytes production under certain diseases against the background of inadequate production of endogenic erythropoietin. The effectiveness of treatment of iron-deficiency anemia is less under decrease of amount of erythrokaryocytes in bone marrow.

Topics: Adult; Aged; Anemia, Iron-Deficiency; Bone Marrow; Erythrocytes; Erythropoiesis; Erythropoietin; Female; Genital Diseases, Female; Hemoglobins; Humans; Leiomyoma; Middle Aged

Topics: Adult; Diagnosis, Differential; Erythropoietin; Female; Humans; Leiomyoma; Polycythemia; Uterine Neoplasms

The rare condition of women with erythrocytosis and a concurrent myomatous uterus has been classified as "myomatous erythrocytosis syndrome". Substantial myoma size has been noted as a common denominator in this condition in which recent evidence have confirmed erythropoietin (Epo) production by myoma tissues themselves. Apart from its primary endocrine role in controlling erythropoiesis, Epo has been demonstrated to mediate several cellular processes such as angiogenesis, mitogenesis, and inhibition of apoptosis by autocrine and paracrine mechanisms. Recently, Epo and its receptor (Epo-R) have been shown to be involved in the growth, viability, and angiogenesis of several malignant tumors including human female reproductive organ malignancies. In this paper, we researched on Epo and, as a first in the literature, Epo-R immunoexpression in a large uterine myoma of a term pregnant patient suffering from the myomatous erythrocytosis syndrome. Eight nongravidic leiomyomas and 8 gravidic leiomyomas were used as control group samples. Apart from confirming Epo production by myoma smooth muscle cells in the myomatous erythrocytosis syndrome, we reveal in this pathologic condition a characteristic strong Epo-R expression in myoma endothelial cells and a weak and sporadic Epo-R expression in myoma smooth muscle cells. The striking presence of Epo-R within myoma tissues in the case of the myomatous erythrocytosis syndrome allows us to speculate that myoma Epo production, besides determining erythrocytosis through systemic effects, may contribute, acting by autocrine and paracrine mechanisms, in determining the large myoma size almost always observed in this condition. Finally, we confirm a less but specific immunostaining for Epo in uterine myomas of patients without erythrocytosis and, as a first in the literature, we prove a weak and sporadic Epo-R expression in these lesions. These last results may contribute to knowledge of the yet unclear etiopathogenesis of the most common human gynecologic neoplasm.

Topics: Adult; Erythropoietin; Female; Humans; Immunohistochemistry; Leiomyoma; Polycythemia; Pregnancy; Receptors, Erythropoietin; Uterine Neoplasms

Various etiologies of myomatous erythrocytosis syndrome (erythrocytosis associated with a uterine leiomyoma), one of which is altered production of erythropoietin, have been proposed. We report a case of erythrocytosis associated with a large uterine leiomyoma in which erythropoietin activity and immunostaining for erythropoietin in the leiomyoma were found.. A 64-year-old woman, gravida 2, para 1, was referred to our department for treatment of a large uterine myoma and erythrocytosis with elevated levels of erythropoietin. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and the results of the pathological examination confirmed the diagnosis of leiomyoma of the uterus, which weighed 920 g. The patient's postoperative course was satisfactory, and the levels of hemoglobin and erythropoietin were normalized and remained within normal ranges. The level of erythropoietin in the uterine leiomyoma measured by radioimmunoassay was elevated (372 mU/wet gram), and specific immunostaining for erythropoietin was found in the cytoplasm of leiomyoma cells. The levels of erythropoietin extracted from uterine leiomyomas of other patients who did not have erythrocytosis (control patients, n = 5) were lower (65 +/- 15.3 mU/wet gram), but specific immunostaining for erythropoietin was also found in the cytoplasm of leiomyoma cells from those patients.. Our case was typical of myomatous erythrocytosis syndrome in which uterine leiomyoma was proved to produce erythropoietin. Our results also suggest that erythropoietin is produced in uterine leiomyomas of patients with and without erythrocytosis. Leiomyoma of the uterus may affect the production of erythropoietin and may develop into myomatous erythrocytosis syndrome when the level of erythropoietin exceeds the normal range.

Topics: Erythropoietin; Female; Humans; Leiomyoma; Middle Aged; Polycythemia; Uterine Neoplasms

We report a patient with uterine myoma (leiomyoma) and erythrocytosis in whom erythropoietin (Epo) production in the leiomyoma tissue was identified by reverse transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). A 48-year-old Japanese woman with uterine myoma showed marked erythrocytosis (haemoglobin: 20.2 g/dl, haematocrit: 61.1%, red blood cells: 6.51 x 10(12)/1). After hysterectomy, erythrocytosis rapidly disappeared. In the leiomyoma tissue collected from the patient, Epo mRNA expression was confirmed using RT-PCR. Furthermore, ELISA showed that the Epo protein level was significantly increased compared with those in control tissues. It is suggested that the pathogenesis of erythrocytosis in patients with uterine myoma involves ectopic Epo production by leiomyoma tissues.

Topics: Enzyme-Linked Immunosorbent Assay; Erythropoietin; Female; Humans; Hysterectomy; Leiomyoma; Middle Aged; Polycythemia; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Uterine Neoplasms

Myomatous erythrocytosis syndrome (erythrocytosis associated with a uterine myoma) has multiple proposed etiologies, one of which is altered erythropoietin production.. A 28-year-old woman, gravida 0, para 0, presented with a solitary, degenerated uterine myoma that was 34-36 weeks' gestational size and erythrocytosis. After GnRH agonist treatment and myomectomy, the tumor was analyzed by reverse transcription-polymerase chain reaction. Specific erythropoietin primer with erythropoietin messenger RNA was noted.. Erythropoietin production by myomata might cause erythrocytosis in myomatous erythrocytosis syndrome.

Topics: Adult; Erythropoietin; Female; Gene Expression; Humans; Leiomyoma; Polycythemia; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Uterine Neoplasms

Topics: Adult; Anemia, Hypochromic; Erythropoietin; Female; Humans; Leiomyoma; Polycythemia; Uterine Neoplasms

Topics: Adult; Animals; Erythropoietin; Female; Humans; Hysterectomy; Leiomyoma; Mice; Polycythemia; Uterine Neoplasms

A case of polycythaemia secondary to uterine fibromyoma is reported. Polycythaemia disappeared after hysterectomy. Erythropoietic activity was detected in the cyst fluid of the tumour. Plasma and urine contained no erythropoietic factor. Polycythaemia was related to erythropoietinlike material produced by the tumour.

Topics: Erythropoiesis; Erythropoietin; Female; Humans; Hysterectomy; Leiomyoma; Middle Aged; Polycythemia; Uterine Neoplasms

A patient with leiomyomata of the skin and erythrocytosis is reported. After surgical removal of the larger skin tumours there was remission of the haematologic abnormalities and the erythrocytosis and the red cell mass decreased to normal levels. The raised serum erythropoietin levels were reduced but remained slightly elevated and less than those recorded prior to surgery. Tumour extracts contained significant erythropoietic activity. This seems to be the first documented case of erythrocytosis associated with skin leiomyomata.

Topics: Erythropoiesis; Erythropoietin; Humans; Leiomyoma; Male; Middle Aged; Neoplasms, Multiple Primary; Polycythemia; Skin Neoplasms

Erythrocytosis has been observed to occur infrequently in association with uterine fibromyomas. Study of this case revealed erythrocytosis prior to surgery and a remission was noted after myomectomy. Elevated erythropoietin activity in this patient's serum was demonstrated. The erythropoietin activity in the tumor tissue extract was 10 times higher than in the control tissue extract. We postulate that the tumor itself was responsible for the erythrocytosis observed. The mechanisms proposed to explain polycythemia in such a tumor were revised and our conclusion is that the tumor produced the erythropoietin autonomously and is not subjected to feedback control mechanism.

Topics: Adult; Erythropoietin; Female; Humans; Leiomyoma; Polycythemia; Uterine Neoplasms

Topics: Adenoma; Adult; Erythropoietin; Female; Humans; Kidney Neoplasms; Leiomyoma; Male; Meningioma; Middle Aged; Neoplasms; Polycythemia; Stomach Neoplasms; Uterine Neoplasms

Topics: Animals; Dialysis; Erythrocyte Count; Erythropoietin; Female; Goats; Hematocrit; Hemoglobins; Humans; Leiomyoma; Mice; Middle Aged; Polycythemia; Rabbits; Uterine Neoplasms; Veins

Topics: Erythropoietin; Female; Humans; Japan; Leiomyoma; Middle Aged; Polycythemia; Uterine Neoplasms

Topics: Adult; Blood Volume; Bone Marrow Cells; Erythrocyte Count; Erythropoietin; Female; Hematocrit; Humans; Leiomyoma; Microscopy, Electron; Polycythemia; Reticulocytes; Uterine Neoplasms; Uterus

Topics: Adult; Biological Assay; Blood Volume; Erythropoietin; Female; Humans; Leiomyoma; Polycythemia; Urography; Uterine Neoplasms

Topics: Aged; Animals; Erythropoietin; Female; Humans; Hysterectomy; Leiomyoma; Mice; Middle Aged; Polycythemia; Uterine Neoplasms

Topics: Adult; Animals; Biological Assay; Blood Cell Count; Blood Volume Determination; Bone Marrow Cells; Cattle; Culture Techniques; Dogs; Erythropoietin; Esophageal Neoplasms; Esophagus; Hematocrit; Humans; Iron Isotopes; Kidney; Leiomyoma; Male; Mice; Polycythemia; Radiography, Thoracic; Tissue Extracts; Tomography

Topics: Aged; Erythropoietin; Female; Humans; Leiomyoma; Middle Aged; Polycythemia; Uterine Neoplasms