@article{10.1093/ehjci/jead208,

title = {Arterial and venous thrombosis after long-term and excessive feminizing gender-affirming hormone therapy in a transgender woman},

author = {Makoto Kambayashi and Kazunori Omote and Takuma Sato and Toshihisa Anzai},

url = {https://doi.org/10.1093/ehjci/jead208},

doi = {10.1093/ehjci/jead208},

issn = {2047-2404},

year  = {2023},

date = {2023-01-01},

journal = {European Heart Journal - Cardiovascular Imaging},

volume = {24},

number = {12},

pages = {e301-e301},

abstract = {A 52-year-old transgender woman was referred for evaluation and treatment of sudden onset of right lower abdominal pain and coldness in the right lower extremity. A contrast-enhanced computed tomography (CT) showed massive thrombus in the descending thoracic aorta (Panels A and B), right common iliac artery and popliteal artery (Panels C and D), and pulmonary artery (Panel E). The protein C and protein S activity, cardiolipin antibody, lupus anticoagulant, and homocysteine levels were normal; however, the patient had a history of feminizing gender-affirming hormone therapy (GAHT), 5.0 mg/day conjugated oestrogens, 0.1 mg/day ethinyloestradiol, and 100 mg/day progesterone by an unofficial import for 8 years, which were higher than the recommended doses. For treatment, continuous intravenous infusion of unfractionated heparin was administrated, and 2 days after admission, the patient suddenly complained of left-sided abdominal pain. A contrast-enhanced CT revealed a new-onset splenic infarction (Panel F). The patient's abdominal pain improved immediately and did not require surgery. The treatment was switched from intravenous heparin to oral warfarin, and the thrombus improved gradually.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}