Keep in Mind: Pulmonary Embolism Due to the Use of Clomiphene Citrate

A 28-year-old female patient was admitted with ongoing chest pain for one day, having started treatment for ovulatory dysfunction with clomiphene citrate 20 days prior. The patient's pulse rate was 120 bpm and blood pressure was 100/60 mmHg. Sinus tachycardia was detected on electrocardiography. Both hypoxia and hypocapnia were detected on an arterial blood gas test. The patient’s d-dimer level was measured as 5.2 µg/ml. A computed tomography angiography revealed filling defects in the right lower lobe pulmonary artery and lower lobe segment branches, consistent with pulmonary embolism. The ejection fraction was 65% on the transthoracic echocardiography and no thrombus was observed. The patient was diagnosed with pulmonary embolism due to clomiphene citrate use, and started on anticoagulation therapy with bemiparin sodium, and was subsequently discharged. Acute pulmonary embolism due to the use of clomiphene citrate is an uncommon but life-threatening complication when encountered. Physicians should be aware of the potential risk of pulmonary embolism.

Akýlda Tut: Klomifen Sitrat Kullanýmýna Baðlý Pulmoner Emboli

Yirmi sekiz yaþýndaki bayan hasta bir gündür devam eden göðüs aðrýsý nedeniyle baþvurdu. Ovulatuar disfonksiyonun klomifen sitrat ile tedavisi 20 gün önce baþlatýlmýþtý. Hastanýn nabýz hýzý 120 vuru / dakika ve kan basýncý 100/60 mmHg idi. Elektrokardiyografide sinüs taþikardisi saptandý. Arteriyel kan gazý testi sonucunda hem hipoksi hem de hipokapni tespit edildi. D-dimer seviyesi 5.2 µg / ml olarak ölçüldü. Bilgisayarlý tomografi anjiyografisinde sað alt lob pulmoner arter ve alt lob segment dallarýnda pulmoner emboli ile uyumlu dolum defektleri görüldü. Transtorasik ekokardiyografide ejeksiyon fraksiyonu% 65 idi ve trombüs izlenmedi. Hastaya klomifen sitrat kullanýmýna baðlý pulmoner emboli tanýsý kondu. Bemiparin sodyum ile antikoagülan tedavi baþlandý ve hasta taburcu edildi. Klomifen sitrat kullanýmýna baðlý akut pulmoner emboli, nadir görülen ancak karþýlaþýldýðýnda yaþamý tehdit eden bir komplikasyon olabilir. Doktorlar olasý pulmoner emboli riskinin farkýnda olmalýdýr.