Thrombotic microangiopathy following a minor gynaecological procedure in the setting of endometrial cancer: a case report

Case Rep Womens Health. 2021 Aug 20:32:e00354. doi: 10.1016/j.crwh.2021.e00354. eCollection 2021 Oct.

Abstract

Hysteroscopy dilatation and curettage is a common minor gynaecological procedure utilised for diagnostic or therapeutic purposes. A 62-year-old woman underwent a hysteroscopy, dilatation and curettage for investigation of prolonged post-menopausal bleeding. Unexpected uterine haemorrhage was encountered without evidence of uterine perforation causing haemodynamic instability. A thrombotic microangiopathy was triggered, leading to microangiopathic haemolytic anaemia, thrombocytopaenia and evidence of micro-thrombosis causing stroke and end-organ dysfunction, including acute renal failure. The histopathology confirmed stage 1 endometrioid adenocarcinoma. This is the first case report of a thrombotic microangiopathy leading to microangiopathic haemolytic anaemia in a patient with endometrioid adenocarcinoma FIGO grade 1, stage 1B following a minor gynaecological procedure.

Keywords: Diagnostic hysteroscopy; Macroangiopathic haemolytic anaemia; Thrombotic microangiopathy; dilatation and curettage.

Publication types

  • Case Reports