High rate of endometrial hyperplasia in renal transplanted women.
A high rate of endometrial hyperplasia, an estrogen-dependent premalignant lesion of the endometrium, has been observed among female kidney allograft recipients. The aim of the study was to evaluate the incidence of endometrial abnormalities among renal transplanted women with abnormal uterine bleedings.


METHODS
A retrospective analysis compared 45 renal transplanted women who underwent dilatation and curettage for abnormal uterine bleeding between January 1999 and September 2004 with 90 consecutive, nontransplanted, control patients who underwent dilatation and curettage for the same reason in 2004.


RESULTS
Thirty-one cases (69%) of endometrial hyperplasia and one case (2%) of endometrial cancer were detected among the renal allograft recipients. The majority of transplant patients (28 cases, 62%) developed endometrial hyperplasia without atypia successfully treated with progestagens. There were 29 cases (32%) of hyperplasia without atypia, 2 cases (1%) of atypical hyperplasia, and 4 cases (4%) of endometrial cancer in the control group.


CONCLUSIONS
Renal transplanted women seem to have an extremely high risk of endometrial hyperplasia. The majority of cases may be successfully treated with progestagens. Immunocompromised renal graft recipients, however, show other risk factors for carcinogenesis. Thus, frequent clinical surveillance should be recommended in this group of patients, also because there is conflicting evidence with regard to the risk of progression to carcinoma among untreated patients.
Bobrowska
K
K
First Department of Obstetrics and Gynecology, Warsaw Medical University, Pl. Starynkiewicza 1/3, 02-015 Warsaw, Poland. kasiabobrowska@yahoo.com
Kamiński
P
P
Cyganek
A
A
Pietrzak
B
B
Jabiry-Zieniewicz
Z
Z
Durlik
M
M
Paczek
L
L
D000328:Adult; D004107:Dilatation and Curettage; D004714:Endometrial Hyperplasia / Q000453:epidemiology*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008875:Middle Aged; D012189:Retrospective Studies; D014592:Uterine Hemorrhage / Q000601:surgery
D007166:Immunosuppressive Agents