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接受氨甲环酸治疗时发生双侧肺栓塞:一例报告

Bilateral pulmonary embolism while receiving tranexamic acid: a case report.

作者信息

Ijaopo Ezekiel Oluwasayo, Ijaopo Ruth Oluwasolape, Adjei Sampson

机构信息

East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, Kent, UK.

University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.

出版信息

J Med Case Rep. 2020 Nov 6;14(1):212. doi: 10.1186/s13256-020-02545-z.

Abstract

BACKGROUND

We present a case of a suspected tranexamic acid-related bilateral pulmonary embolism in a healthy and active middle-aged woman who was receiving tranexamic acid for menorrhagia with no other known significant risk factors for thromboembolism.

CASE PRESENTATION

A 46-year-old Asian woman who was usually fit and well with no remarkable past medical history except for menorrhagia of 1-year duration for which she was receiving tranexamic acid presented to our accident and emergency department with a 2-week history of intermittent pleuritic central chest pain. She was reviewed and discharged to home with a diagnosis of musculoskeletal pain on two hospital visits because she had no significant risk factors for thromboembolism and her workup investigation results for pulmonary embolism and other differential diagnoses were largely unremarkable. On her third visit to the emergency ambulatory clinic with recurring symptoms of pleuritic chest pain, a pulmonary computed tomographic angiogram confirmed bilateral subsegmental pulmonary embolism.

CONCLUSION

This case report reinforces the possible increased risk of thromboembolism in patients receiving tranexamic acid.

摘要

背景

我们报告一例疑似氨甲环酸相关的双侧肺栓塞病例,患者为一名健康、活跃的中年女性,因月经过多接受氨甲环酸治疗,无其他已知的重大血栓栓塞风险因素。

病例介绍

一名46岁的亚洲女性,通常身体健康,除了持续1年的月经过多外无明显既往病史,因月经过多正在接受氨甲环酸治疗。她因间歇性胸膜性中央胸痛2周就诊于我们的急诊科。她在两次住院就诊时经检查后被诊断为肌肉骨骼疼痛并出院,因为她没有血栓栓塞的重大风险因素,且她的肺栓塞及其他鉴别诊断的检查结果大多无异常。在她第三次因复发性胸膜性胸痛症状就诊于急诊门诊时,肺部计算机断层血管造影证实为双侧亚段肺栓塞。

结论

本病例报告强化了接受氨甲环酸治疗的患者血栓栓塞风险可能增加的观点。

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