Aortic mural thrombosis with bilateral renal infarction in a woman taking dienogest for adenomyosis: A case report and literature review

IF 2.2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2025-09-01 DOI:10.1016/j.tjog.2024.08.015

Kuang-Yen Lee , Chieh-Lung Cheng , Ying-Cheng Chiang

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Abstract

Objective

We presented a rare case of aortic mural thrombosis with bilateral renal infarction in a woman taking dienogest for adenomyosis. The objective is to highlight the possible risk of thrombosis in woman with antiphospholipid syndrome taking progestin-only contraceptives for endometriosis.

Case report

We presented a 48-year-old woman who has adenomyosis for years. After using dienogest for 1 month, she experienced severe abdominal pain and was diagnosed to have dienogest-induced aortic mural thrombosis and bilateral renal infarction. Successful treatment was achieved with the use of heparin followed by edoxaban. Intriguingly, the patient was diagnosed to have antiphospholipid syndrome 4 months later. The patient remained under regular follow-up for two years, during which no further thrombotic episodes were noted.

Conclusion

Progestin-only contraceptives may be an acceptable choice for patients with adenomyosis and antiphospholipid syndrome, the risk of thrombosis should still be kept in mind.

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主动脉壁血栓形成合并双侧肾梗死1例，并文献复习

目的报告一例罕见的双侧肾梗死并发主动脉壁血栓形成的病例。目的是强调可能的血栓形成的风险，抗磷脂综合征的妇女服用孕激素避孕药子宫内膜异位症。病例报告我们报告了一位48岁的女性，她患有子宫腺肌症多年。用药1个月后，患者出现剧烈腹痛，并被诊断为地诺孕酮所致主动脉壁血栓形成及双侧肾梗死。使用肝素和依多沙班治疗成功。有趣的是，4个月后，患者被诊断出患有抗磷脂综合征。患者接受了两年的定期随访，在此期间没有进一步的血栓发作。结论单纯孕激素避孕药可能是子宫腺肌症合并抗磷脂综合征患者可接受的选择，但仍应注意血栓形成的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.