Bragg Kara, Miller Hailey, Buckshaw Ricky, Simon Leslie V, King Courtney
Emergency Medicine, Mayo Clinic, Jacksonville, USA.
Internal Medicine, Mayo Clinic, Jacksonville, USA.
Cureus. 2024 Jul 1;16(7):e63611. doi: 10.7759/cureus.63611. eCollection 2024 Jul.
Healthcare providers in the emergency department (ED) diagnose and treat venous thrombus embolism (VTE). Current VTE clinical decision tools specifically mention estrogen but do not include the use of testosterone replacement therapy (TRT). A male in the early third decade of life presented to the ED with complaints of left calf pain and subjective swelling for one week. The patient was low risk using VTE scoring tools. The patient had multiple occlusive VTE on lower-extremity ultrasound and extensive central, bilateral segmental, and subsegmental pulmonary emboli. He was admitted to the hospital and placed on a heparin drip. TRT may be seen in clinical practice in both male and female patients. This bodes the question of whether TRT should be added to the risk analysis tools used to evaluate and predict the risk for VTE. There have been conflicting reports in research, with more recent studies indicating the risk associated with TRT. This case study demonstrates the risk of VTE with TRT. Further investigation is needed to determine if there is a correlation between VTE and TRT. Clinical decision tools should be updated to include TRT accordingly.
急诊科的医护人员负责诊断和治疗静脉血栓栓塞症(VTE)。当前的VTE临床决策工具特别提到了雌激素,但未包括睾酮替代疗法(TRT)的使用情况。一名30岁出头的男性因左小腿疼痛和主观肿胀一周就诊于急诊科。使用VTE评分工具评估该患者为低风险。患者下肢超声显示多处闭塞性VTE,并有广泛的中央型、双侧节段性和亚节段性肺栓塞。他被收治入院并接受肝素静脉滴注治疗。在临床实践中,男性和女性患者都可能会使用TRT。这就引发了一个问题,即TRT是否应被纳入用于评估和预测VTE风险的分析工具中。研究报告存在相互矛盾的情况,最近的研究表明TRT存在相关风险。本病例研究证明了TRT会导致VTE风险。需要进一步调查以确定VTE与TRT之间是否存在关联。临床决策工具应相应更新,将TRT纳入其中。