CASE REPORT
Pulmonary embolism associated with oral contraceptive use – Case report
 
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Department of Internal Medicine, Medical University of Lublin, Poland
 
 
Corresponding author
Jerzy Mosiewicz   

Department of Internal Medicine, Medical University, Lublin, Poland
 
 
J Pre Clin Clin Res. 2014;8(2):120-122
 
KEYWORDS
ABSTRACT
A 25-year-old female patient with a history of oral contraceptive use was admitted to hospital because of exertional dyspnoea, palpitations, chest discomfort and weakness. Since the clinical presentation was suggestive of some heart disease the patient underwent echocardiography which revealed indirect signs of acute pulmonary embolism. The diagnosis was confirmed with multisliced computed tomography of the pulmonary arteries. Blood test results raised suspicion of antithrombin III deficiency. Enoxaparin and warfarin were used as treatment regimen with good effect and the patient was discharged home without significant symptoms, signs, and with normal echocardiography.
 
REFERENCES (23)
1.
Guidelines on the diagnosis and treatment of pulmonary embolism. Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European society of Cardiology. Eur Heart J. 2008; 29: 2276–2315.
 
2.
Plu-Bureau G, Maitrot-Mantelet L, Hugon-Rodin J, Canonico M. Hormonal contraceptives and venous thromboembolism: an epidemiological update. Best Pract Res Clin Endocrinol Metab. 2013; 27(1): 25–34.
 
3.
Dinger JC, Heinemann LA, Kühl-Habich D. The safety of a drospirenone-containing oral contraceptive: final results from the European Active Surveillance Study on oral contraceptives based on 142,475 women-years of observation. Contraception. 2007; 75(5): 344–354.
 
4.
van Hylckama Vlieg A, Helmerhorst FM, Vandenbroucke JP, Doggen CJ, Rosendaal FR. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study. BMJ. 2009; 339: 2921.
 
5.
Gronich N, Lavi I, Rennert G. Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based cohort study. CMAJ. 2011; 183(18): 1319–1325.
 
6.
Lidegaard Ø, Løkkegaard E, Svendsen AL, Agger C. Hormonal contraception and risk of venous thromboembolism: national follow-up study. BMJ. 2009; 339: 2890.
 
7.
Heinemann LA, Dinger JC, Assmann A, Minh TD. Use of oral contraceptives containing gestodene and risk of venous thromboembolism: outlook 10 years after the third-generation “pill scare”. Contraception 2010; 81(5): 401–407.
 
8.
Vaillant-Roussel H, Ouchchane L, Dauphin C, Philippe P, Ruivard M. Risk factors for recurrence of venous thromboembolism associated with the use of oral contraceptives. Contraception 2011; 84(5): 23–30.
 
9.
Dinger J, Assmann A, Möhner S, Minh TD. Risk of venous thromboembolism and the use of dienogest- and drospirenone-containing oral contraceptives: results from a German case-control study. J Fam Plann Reprod Health Care. 2010; 36(3): 123–129.
 
10.
Chroustova D, Kubinyi J, Jansa P, Veprekova L, Trnka J. V/P scan in diagnosis and follow-up of pulmonary embolism in 15–25-year-old females in relation to hormonal contraception use. Nucl Med Rev Cent East Eur. 2011; 14(2): 63–67.
 
11.
Rott H. Thrombotic risks of oral contraceptives. Curr Opin Obstet Gynecol. 2012; 24(4): 235–240.
 
12.
Khan S, Smulders YM, de Vries JI, Spoelstra-de Man AM. Life-threatening complications of hormonal contraceptives: a case history. Case Rep Obstet Gynecol. 2013; 186–230.
 
13.
Klipping C, Duijkers I, Parke S, Mellinger U, Serrani M, Junge W. Hemostatic effects of a novel estradiol-based oral contraceptive: an open-label, randomized, crossover study of estradiol valerate/dienogest versus ethinylestradiol/levonorgestrel. Drugs R D. 2011; 11(2): 159–170.
 
14.
Legnani C, Palareti G, Guazzaloca G, Cosmi B, Lunghi B, Bernardi F, Coccheri S. Venous thromboembolism in young women; role of thrombophilic mutations and oral contraceptive use. Eur Heart J. 2002; 23(12): 984–990.
 
15.
Patnaik MM, Moll S. Inherited antithrombin deficiency: a review. Haemophilia 2008; 14(6): 1229–1239.
 
16.
Landesberg WH. Pulmonary embolism in a female collegiate cross-country runner presenting as nonspecific back pain. J Chiropr Med. 2012; 11(3): 215–220.
 
17.
Martínez F, Ramírez I, Pérez-Campos E, Latorre K, Lete I. Venous and pulmonary thromboembolism and combined hormonal contraceptives. Systematic review and meta-analysis. Eur J Contracept Reprod Health Care. 2012; 17(1): 7–29.
 
18.
Lenicek Krleza J, Jakovljevic G, Bronic A, Coen Herak D, Bonevski A, Stepan-Giljevic J, Roic G. Contraception-related deep venous thrombosis and pulmonary embolism in a 17-Year-old girl heterozygous for factor V Leiden, prothrombin G20210A mutation, MTHFR C677T and homozygous for PAI-1 mutation: report of a family with multiple genetic risk factors and review of the literature. Pathophysiol Haemost Thromb. 2010; 37(1): 24–29.
 
19.
Turan O, Ündar B, Günay T, Akkoçlu A. Investigation of inherited thrombophilias in patients with pulmonary embolism. Blood Coagul Fibrinolysis. 2013; 24(2): 140–149.
 
20.
Ivanov P, Komsa-Penkova R, Kovacheva K, Ivanov Y, Stoyanova A, Ivanov I, Pavlov P, Glogovska P, Nojarov V. Impact of thrombophilic genetic factors on pulmonary embolism: early onset and recurrent incidences. Lung 2008; 186(1): 27–36.
 
21.
Maclean PS, Tait RC. Hereditary and acquired antithrombin deficiency: epidemiology, pathogenesis and treatment options. Drugs 2007; 67(10): 1429–1440.
 
22.
De Stefano V, Simioni P, Rossi E, Tormene D, Za T, Pagnan A, Leone G. The risk of recurrent venous thromboembolism in patients with inherited deficiency of natural anticoagulants antithrombin, protein C and protein S. Haematologica 2006; 91(5): 695–698.
 
23.
Takahashi J, Ito M, Okude J, Gohda T, Wakamatsu Y, Sasaki S, Yasuda K. Pulmonary thromboembolectomy in congenital antithrombin III deficiency associated with acute pulmonary embolism – report of a case. Ann Thorac Cardiovasc Surg. 2003; 9(3): 192–19.
 
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