Hitosugi M, Kitamura O, Takatsu A, Watanabe K, Kan S
Department of Forensic Medicine, Jikei University, School of Medicine, Tokyo, Japan.
Nihon Hoigaku Zasshi. 1997 Dec;51(6):452-6.
It is reported that medroxyprogesterone acetate (MPA) causes venous thrombosis as one of the side effects. A 49-year-old woman suffering from metastatic lung carcinoma from breast carcinoma was administered MPA 1200 mg/day for about four months. Thereafter she complained of dizziness about two weeks but the general practitioners could detect no abnormality on physical examinations and on brain CT X-ray findings. Six days later, she died suddenly at her home. Forensic autopsy findings revealed the marked superior sagital sinus thrombosis and the malignant lymphadenomatosis caused by metastatic lung carcinoma. As the patient had not disease or trauma causing dural sinus thrombosis except for the administration of MPA, we concluded that superior sagital sinus thrombosis was due to the medication of MPA. This case illustrates that forensic pathologist should consider the major side effect of some drugs like our case.
据报道，醋酸甲羟孕酮（MPA）可导致静脉血栓形成，这是其副作用之一。一名49岁患有乳腺癌转移性肺癌的女性，每天服用1200毫克MPA，持续约四个月。此后，她抱怨头晕约两周，但全科医生在体格检查和脑部CT X光检查中未发现异常。六天后，她在家中突然死亡。法医尸检结果显示，存在明显的上矢状窦血栓形成以及由转移性肺癌引起的恶性淋巴瘤。由于除服用MPA外，患者没有导致硬脑膜窦血栓形成的疾病或创伤，我们得出结论，上矢状窦血栓形成是由MPA用药引起的。本病例表明，法医病理学家应像我们的病例一样考虑某些药物的主要副作用。
