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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 590-595    DOI: 10.31083/j.ceog.2020.04.5062
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The possible involvement of interleukin-6 in congestive heart failure in a postmenopausal woman with uterine fibromatosis
M. Ohta1, *(), N. Keira2, S. Yoshida1, R. Yasuda1, Y. Tarumi3, H. Tsuchiya3, M. Kikai2, T. Nomura2, T. Tatsumi2
1Department of Obstetrics and Gynecology, Chibune General Hospital, Osaka, Japan
2Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
3Department of Obstetrics and Gynecology, Kyoto Chubu Medical Center, Kyoto, Japan
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Abstract  

Interleukin-6 (IL-6) has been shown to contribute to the progression of myocardial damage and dysfunction in congestive heart failure. We report a case of a 53-year old woman with congestive heart failure that may have been caused by IL-6 secreting uterine leiomyoma. The woman developed progressive dyspnea, pleural effusion, and leg edema with a decreased left ventricular ejection fraction (LVEF). Imaging studies indicated uterine leiomyoma compressing the vena cava. Due to unresponsiveness to conventional medical treatment, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy to alleviate compression of the vena cava. After surgery, pleural effusion and leg edema completely resolved. Concomitant with the subsequent improvement of LVEF, a pre-operative serum IL-6 measurement of 36.2 pg/mL fell to 1.6 pg/mL postoperatively. Immunologically positive staining for IL-6 was demonstrated in the cytoplasm of most of the uterine leiomyoma cells. These findings suggest that IL-6 produced by leiomyoma cells may have been involved in the pathophysiological progression of heart failure and associated hemodynamic changes.

Key words:  Leiomyoma      Interleukin-6      Heart failure      Pleural effusion     
Submitted:  20 November 2018      Accepted:  21 January 2019      Published:  15 August 2020     
*Corresponding Author(s):  M. Ohta     E-mail:  tam.arta0119@gmail.com

Cite this article: 

M. Ohta, N. Keira, S. Yoshida, R. Yasuda, Y. Tarumi, H. Tsuchiya, M. Kikai, T. Nomura, T. Tatsumi. The possible involvement of interleukin-6 in congestive heart failure in a postmenopausal woman with uterine fibromatosis. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 590-595.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.5062     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/590

Figure 1.  — A chest X-ray showing an enlarged cardio-thoracic ratio with right-sided pleural effusion.

Figure 2.  — There were no abnormal findings on angiography for right coronary artery (A) and left coronary artery (B).

Figure 3.  — An enhanced abdominal computed tomography showing uterine leiomyoma. (A) Coronary section, (B) Sagittal section.

Figure 4.  — A magnetic resonance imaging displaying a well-circumscribed solid tumor with hypointensity on T1- (A), enhanced T1W- (B), and T2-weighted images (C).

Figure 5.  — A macroscopic finding of uterine leiomyoma.

Figure 6.  — A chest X-ray on 27 days postoperation.

Figure 7.  — Immunohistochemical analyses of IL-6 and TNF-α in uterine leiomyoma tissues. The cytoplasms of leiomyoma cells were diffusely immunopositive for IL-6 (B). A; negative control for IL-6. Leiomyoma cells were immunonegative for TNF-α (D). C; negative control.

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