Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature
Abstract
:1. Introduction
2. Case Report
3. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Sagoe, D.; Molde, H.; Andreassen, C.S.; Torsheim, T.; Pallesen, S. The global epidemiology of anabolic-androgenic steroid use: A meta-analysis and meta-regression analysis. Ann. Epidemiol. 2014, 24, 383–398. [Google Scholar] [CrossRef] [PubMed]
- Pope, H.G., Jr.; Wood, R.I.; Rogol, A.; Nyberg, F.; Bowers, L.; Bhasin, S. Adverse health consequences of performance-enhancing drugs: An Endocrine Society scientific statement. Endocr. Rev. 2014, 35, 341–375. [Google Scholar] [CrossRef] [PubMed]
- Buckman, J.F.; Farris, S.G.; Yusko, D.A. A national study of substance use behaviors among NCAA male athletes who use banned performance enhancing substances. Drug Alcohol Depend. 2013, 131, 50–55. [Google Scholar] [CrossRef] [PubMed]
- Ip, E.J.; Lu, D.H.; Barnett, M.J.; Tenerowicz, M.J.; Vo, J.C.; Perry, P.J. Psychological and physical impact of anabolic-androgenic steroid dependence. Pharmacotherapy 2012, 32, 910–919. [Google Scholar] [CrossRef]
- NIDA. How Are Anabolic Steroids Used? 22 November 2021. Available online: https://nida.nih.gov/publications/research-reports/steroids-other-appearance-performance-enhancing-drugs-apeds/how-are-anabolic-steroids-used (accessed on 7 December 2022).
- de Ronde, W.; Smit, D.L. Anabolic androgenic steroid abuse in young males. Endocr. Connect. 2020, 9, R102–R111. [Google Scholar] [CrossRef] [PubMed]
- Turetz, M.; Sideris, A.T.; Friedman, O.A.; Triphathi, N.; Horowitz, J.M. Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Semin. Interv. Radiol. 2018, 35, 92–98. [Google Scholar] [CrossRef]
- Horlander, K.T.; Mannino, D.M.; Leeper, K.V. Pulmonary Embolism Mortality in the United States, 1979–1998: An analysis using multiple-cause mortality data. Arch. Intern. Med. 2003, 163, 1711–1717. [Google Scholar] [CrossRef]
- Stein, P.D.; Beemath, A.; Matta, F.; Weg, J.G.; Yusen, R.D.; Hales, C.A.; Hull, R.D.; Leeper, K.V.; Sostman, H.D.; Tapson, V.F.; et al. Clinical Characteristics of Patients with Acute Pulmonary Embolism: Data from PIOPED II. Am. J. Med. 2007, 120, 871–879. [Google Scholar] [CrossRef]
- Di Nisio, M.; van Es, N.; Büller, H.R. Deep vein thrombosis and pulmonary embolism. Lancet 2016, 388, 3060–3073. [Google Scholar] [CrossRef] [PubMed]
- Lee, K.; Toraby, S.; Cotterman, R.; Oriowo, B.; Fish, J. A Tumultuous Course of Exogenous Testosterone by a Bodybuilder Causing a Catastrophic Hypercoagulable State in the Surgical Intensive Care Unit. Case Rep. Vasc. Med. 2019, 2019, 3097865. [Google Scholar] [CrossRef] [PubMed]
- Liljeqvist, S.; Helldén, A.; Bergman, U.; Söderberg, M. Pulmonary embolism associated with the use of anabolic steroids. Eur. J. Intern. Med. 2008, 19, 214–215. [Google Scholar] [CrossRef] [PubMed]
- Nguyen, S.M.; Ko, N.K.; Sattar, A.S.; Ipek, E.G.; Ali, S. Pulmonary Embolism Secondary to Testosterone-Enhancing Herbal Supplement Use. Cureus 2017, 9, e1545. [Google Scholar] [CrossRef] [PubMed]
- Handelsman, D.J. Androgen Misuse and Abuse. Endocr. Rev. 2021, 42, 457–501. [Google Scholar] [CrossRef]
- Montisci, M.; El Mazloum, R.; Cecchetto, G.; Terranova, C.; Ferrara, S.D.; Thiene, G.; Basso, C. Anabolic androgenic steroids abuse and cardiac death in athletes: Morphological and toxicological findings in four fatal cases. Forensic Sci. Int. 2012, 217, e13–e18. [Google Scholar] [CrossRef] [PubMed]
- Pillai, A.A.; Fazal, S.; Babiker, H.M. Polycythemia. [Updated 10 July 2022]. In StatPearls; StatPearls Publishing: Treasure Island, FL, USA, 2022. Available online: https://www.ncbi.nlm.nih.gov/books/NBK526081 (accessed on 7 December 2022).
- McMullin, M.F.; Bareford, D.; Campbell, P.; Green, A.R.; Harrison, C.; Hunt, B.; Oscier, D.; Polkey, M.I.; Reilly, J.T.; Rosenthal, E.; et al. Guidelines for the diagnosis, investigation and management of polycythaemia/erythrocytosis. Br. J. Haematol. 2005, 130, 174–195. [Google Scholar] [CrossRef]
- Wells, R.E.; Merrill, E.W. Influence of Flow Properties of Blood Upon Viscosity-Hematocrit Relationships. J. Clin. Investig. 1962, 41, 1591–1598. [Google Scholar] [CrossRef]
- Maggio, M.; Snyder, P.J.; Ceda, G.P.; Milaneschi, Y.; Luci, M.; Cattabiani, C.; Masoni, S.; Vignali, A.; Volpi, R.; Lauretani, F.; et al. Is the haematopoietic effect of testosterone mediated by erythropoietin? The results of a clinical trial in older men. Andrology 2013, 1, 24–28. [Google Scholar] [CrossRef]
- Bachman, E.; Feng, R.; Travison, T.; Li, M.; Olbina, G.; Ostland, V.; Ulloor, J.; Zhang, A.; Basaria, S.; Ganz, T.; et al. Testosterone suppresses hepcidin in men: A potential mechanism for testosterone-induced erythrocytosis. J. Clin. Endocrinol. Metab. 2010, 95, 4743–4747. [Google Scholar] [CrossRef] [PubMed]
- Bachman, E.; Travison, T.G.; Basaria, S.; Davda, M.N.; Guo, W.; Li, M.; Westfall, J.C.; Bae, H.; Gordeuk, V.; Bhasin, S. Testosterone Induces Erythrocytosis via Increased Erythropoietin and Suppressed Hepcidin: Evidence for a New Erythropoietin/Hemoglobin Set Point. J. Gerontol. Ser. A Biomed. Sci. Med. Sci. 2014, 69, 725–735. [Google Scholar] [CrossRef]
- Calado, R.T.; Yewdell, W.T.; Wilkerson, K.L.; Regal, J.A.; Kajigaya, S.; Stratakis, C.A.; Young, N.S. Sex hormones, acting on the TERT gene, increase telomerase activity in human primary hematopoietic cells. Blood 2009, 114, 2236–2243. [Google Scholar] [CrossRef]
- Jones, S.D., Jr.; Dukovac, T.; Sangkum, P.; Yafi, F.A.; Hellstrom, W.J. Erythrocytosis and Polycythemia Secondary to Testosterone Replacement Therapy in the Aging Male. Sex Med. Rev. 2015, 3, 101–112. [Google Scholar] [CrossRef] [PubMed]
- Ory, J.; Nackeeran, S.; Balaji, N.C.; Hare, J.M.; Ramasamy, R. Secondary Polycythemia in Men Receiving Testosterone Therapy Increases Risk of Major Adverse Cardiovascular Events and Venous Thromboembolism in the First Year of Therapy. J. Urol. 2022, 207, 1295–1301. [Google Scholar] [CrossRef]
- Ohlander, S.J.; Varghese, B.; Pastuszak, A.W. Erythrocytosis Following Testosterone Therapy. Sex. Med. Rev. 2018, 6, 77–85. [Google Scholar] [CrossRef]
- Madsen, M.C.; van Dijk, D.; Wiepjes, C.M.; Conemans, E.B.; Thijs, A.; Heijer, M.D. Erythrocytosis in a Large Cohort of Trans Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence, Determinants, and Exposure Years. J. Clin. Endocrinol. Metab. 2021, 106, 1710–1717. [Google Scholar] [CrossRef]
- Martinez, C.; Suissa, S.; Rietbrock, S.; Katholing, A.; Freedman, B.; Cohen, A.T.; Handelsman, D.J. Testosterone treatment and risk of venous thromboembolism: Population based case-control study. BMJ 2016, 355, i5968. [Google Scholar] [CrossRef] [PubMed]
- Ajayi, A.A.L.; Mathur, R.; Halushka, P.V. Testosterone Increases Human Platelet Thromboxane A 2 Receptor Density and Aggregation Responses. Circulation 1995, 91, 2742–2747. [Google Scholar] [CrossRef] [PubMed]
- Banerjee, D.; Mazumder, S.; Bhattacharya, S.; Sinha, A.K. The sex specific effects of extraneous testosterone on ADP induced platelet aggregation in platelet-rich plasma from male and female subjects. Int. J. Lab. Hematol. 2014, 36, e74–e77. [Google Scholar] [CrossRef]
- Roşca, A.E.; Vlădăreanu, A.M.; Mititelu, A.; Popescu, B.O.; Badiu, C.; Căruntu, C.; Voiculescu, S.E.; Onisâi, M.; Gologan, Ş.; Mirica, R.; et al. Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review. J. Clin. Med. 2021, 10, 147. [Google Scholar] [CrossRef]
- Coviello, A.D.; Kaplan, B.; Lakshman, K.M.; Chen, T.; Singh, A.B.; Bhasin, S. Effects of Graded Doses of Testosterone on Erythropoiesis in Healthy Young and Older Men. J. Clin. Endocrinol. Metab. 2008, 93, 914–919. [Google Scholar] [CrossRef]
- Cervi, A.; Balitsky, A.K. Testosterone use causing erythrocytosis. Can. Med. Assoc. J. 2017, 189, E1286–E1288. [Google Scholar] [CrossRef]
- Basaria, S.; Coviello, A.D.; Travison, T.G.; Storer, T.W.; Farwell, W.R.; Jette, A.M.; Eder, R.; Tennstedt, S.; Ulloor, J.; Zhang, A.; et al. Adverse Events Associated with Testosterone Administration. N. Engl. J. Med. 2010, 363, 109–122. [Google Scholar] [CrossRef] [PubMed]
- Finkle, W.D.; Greenland, S.; Ridgeway, G.K.; Adams, J.L.; Frasco, M.A.; Cook, M.B.; Fraumeni, J.F., Jr.; Hoover, R.N. Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men. PLoS ONE 2014, 9, e85805. [Google Scholar] [CrossRef] [PubMed]
- Vigen, R. Association of Testosterone Therapy with Mortality, Myocardial Infarction, and Stroke in Men with Low Testosterone Levels. JAMA 2013, 310, 1829–1836. [Google Scholar] [CrossRef] [PubMed]
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Menakuru, S.R.; Atta, M.; Dhillon, V.S.; Salih, A. Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature. Hematol. Rep. 2023, 15, 290-297. https://doi.org/10.3390/hematolrep15020029
Menakuru SR, Atta M, Dhillon VS, Salih A. Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature. Hematology Reports. 2023; 15(2):290-297. https://doi.org/10.3390/hematolrep15020029
Chicago/Turabian StyleMenakuru, Sasmith R., Mona Atta, Vijaypal S. Dhillon, and Ahmed Salih. 2023. "Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature" Hematology Reports 15, no. 2: 290-297. https://doi.org/10.3390/hematolrep15020029