Portal Vein Thrombosis Due to an Increase in Dose of Testosterone in a Young Man with Klinefelter Syndrome

Amjad, Waseem; Khatoon, Salma; Tarasaria, Twara; Sharifova, Gulru

doi:10.7759/cureus.1823

Cited by 1 publication

(2 citation statements)

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“…This case report represents the first report of a patient presenting with both PVT and SMV thrombosis secondary to transdermal testosterone therapy. A PubMed search from 1990 to May 2021 with keywords “testosterone AND portal thrombosis” yielded one result of a case study with reported PVT related to testosterone therapy 14 and one result of a case report with reported PVT and SMV thrombosis with testosterone therapy. 15 When the keywords were changed to “testosterone AND superior mesenteric vein thrombosis” two case reports were found 16,17 including a 55-year-old female on testosterone pellets implant with portomesenteric thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…The first case report involving PVT differs from our patient because the patient had a history of Klinefelter syndrome and was using injectable testosterone, which could have potentially increased the patient’s risk of a thrombotic event. 6,14 Patient reported originally taking injectable testosterone, but had switched to topical testosterone 1 year prior to his thrombosis making it unlikely that the injectable testosterone contributed to this adverse event. The second case report does involve both PVT and SMV thrombosis but differs from our patient as the patient was using injectable testosterone therapy, which is thought to hold a higher risk for thrombotic events than topical treatments.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Portal and Superior Mesenteric Vein Thrombosis with Topical Testosterone Therapy: An Adverse Drug Event Case Report

Adams

Pijut

Uttal-Veroff

et al. 2022

Journal of Pharmacy Practice

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This is a case report of a 55-year-old Caucasian male prescribed topical testosterone therapy for 12 months prior to admission, when he was diagnosed with acute thrombosis in the portal vein (PVT) and superior mesenteric vein (SMV). The patient had a negative thrombophilia workup, including Factor V Leiden, Prothrombin G20210A, and JAK2 V617F mutations. There were no other pertinent laboratory markers that raised concern for the cause of thrombus. No strong familial history of venous thromboembolism (VTE) was reported during the patient’s initial workup. With this in mind, the patient’s use of topical testosterone therapy was considered the most likely risk factor for the PVT and SMV thrombus. During hospitalization, the patient was initiated on therapeutic anticoagulation with a heparin drip and discharged to home on apixaban for 3 months with extended therapy to be determined by outpatient hematologist. With no other identified VTE risk factors, probability that this patient’s VTE was attributed to testosterone was evaluated using the Naranjo scale with a calculated score of 6, which classifies the adverse reaction as “likely.” Clinicians should be aware of the possibility that topical testosterone therapy may be a risk factor for venous thrombosis in unusual sites.

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