{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:40:07Z","timestamp":1756312807164,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,17]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Uterine fibroids can be large enough to cause mechanical obstruction of pelvic ureters, which may result in hydroureters and hydronephrosis. Renal impairment frequently results in hypertension due to increased activity of the tubuloglomerular feedback system and renin\u2013angiotensin\u2013aldosterone axis. This process, however, seems reversible because normalisation of blood pressure is possible after the relief of renal obstruction. We report a rare case of a nulliparous woman with a myomatous uterus and an isolated initial complaint of high blood pressure. After proper diagnostic investigation, a uterine mass of 20 cm causing bilateral hydronephrosis was discovered. A successful myomectomy was conducted, which achieved an intact endometrium lining with posterior normalisation of blood pressure.<\/jats:p>","DOI":"10.1136\/bcr-2021-243270","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T11:55:51Z","timestamp":1626782151000},"page":"e243270","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Arterial hypertension as an inaugural sign of myomatous uterus"],"prefix":"10.1136","volume":"14","author":[{"given":"T\u00e2nia","family":"Ascens\u00e3o","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena Barros","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sid\u00f3nio","family":"Matias","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"\u00c1guas","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"2025082709152777000_14.7.e243270.1","doi-asserted-by":"crossref","first-page":"16043","DOI":"10.1038\/nrdp.2016.43","article-title":"Uterine fibroids","volume":"2","author":"Stewart","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2025082709152777000_14.7.e243270.2","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2012.753421"},{"key":"2025082709152777000_14.7.e243270.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjh.0000234126.78766.00"},{"key":"2025082709152777000_14.7.e243270.4","doi-asserted-by":"crossref","first-page":"607","DOI":"10.2147\/IJWH.S138982","article-title":"Updated approaches for management of uterine fibroids","volume":"9","author":"Mas","year":"2017","journal-title":"Int J Womens Health"},{"key":"2025082709152777000_14.7.e243270.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.grf.0000159538.27221.8c"},{"key":"2025082709152777000_14.7.e243270.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/4039890","article-title":"Nonobstructive acute renal failure with a large solitary fibroid","volume":"2016","author":"Elkattah","year":"2016","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025082709152777000_14.7.e243270.7","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s13669-018-0243-5","article-title":"Natural history of uterine fibroids: a radiological perspective","volume":"7","author":"Ghosh","year":"2018","journal-title":"Curr Obstet Gynecol Rep"},{"key":"2025082709152777000_14.7.e243270.8","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S51083"},{"key":"2025082709152777000_14.7.e243270.9","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1007\/s11606-012-2183-5","article-title":"Hypertension and hydronephrosis: rapid resolution of high blood pressure following relief of bilateral ureteric obstruction","volume":"28","author":"Chalisey","year":"2013","journal-title":"J Gen Intern Med"},{"key":"2025082709152777000_14.7.e243270.10","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s00404-008-0769-2","article-title":"Obstructive nephropathy and chronic kidney disease secondary to uterine leiomyomas","volume":"279","author":"Bansal","year":"2009","journal-title":"Arch Gynecol Obstet"},{"key":"2025082709152777000_14.7.e243270.11","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1080\/03009734.2018.1521890","article-title":"Changes of arterial pressure following relief of obstruction in adults with hydronephrosis","volume":"123","author":"Al-Mashhadi","year":"2018","journal-title":"Ups J Med Sci"},{"key":"2025082709152777000_14.7.e243270.12","unstructured":"National Collaborating Centre for Women\u2019s and Children\u2019s Health (UK) . 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