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Polycythemia and Uterine Myomata

Thomas J. Yeh, MD
JAMA. 1967;201(5):332. doi:10.1001/jama.1967.03130050066032.
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To the Editor:—  In the letter from Drs. Morton, Evans, and Daines on "Polycythemia and Uterine Myomata" (200:419, 1967) it is significant that the arterial oxygen tension prior to surgery was 68.1 mm Hg, representing a significant degree of hypoxia. This obviously cannot be explained on the basis of hypoventilation, since the carbon dioxide tension was only 33.5 mm Hg. I wonder if there is a veno-arterial shunting taking place in the lung in some caes of uterine myomata, as has been observed in cases of cirrhosis of the liver associated with cyanosis and polycythemia. I do not believe the arteriovenous shunting taking place in the uterine myomata can produce either hypoxia or polycythemia. If the hypoxia is corrected by removal of the uterine myomata, this might indicate that the fibroid in some way or other produces substance which increases veno-arterial shunting in the lung. It would be of


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