Respir Case Rep. 2021; 10(2): 122-125 | DOI: 10.5505/respircase.2021.53824

Pulmonary Thromboembolism Associated with Human Chorionic Gonadotropin Misuse: A Case Report

Hülya Dirol¹, Ayþe Ödemiþ², Tülay Özdemir^1
1Department of Chest Diseases, Akdeniz University, Antalya, Turkey
²Department of Chest Diseases, Artvin State Hospital, Artvin, Turkey

Although many years have passed since the first speculation that Human chorionic gonadotropin (hCG) could be effective in obesity treatment, its efficacy in this regard has yet to be proven. Unfortunately, we still come encounter hCG misuse, complicated with pulmonary thromboembolism. A 54-year-old female patient with no prior medical history presented to the outpatient clinic with pleuritic chest pain, but no other respiratory symptoms. Two months earlier, she had applied to a nutrition center to lose weight and had been started on a 125 IU/day subcutaneous hCG injection and a 500 kcal/day diet. After the injections, she experienced such complaints as flushing, breast bulging and minor vaginal bleeding, despite having passed menopause. Her vital signs and all physical examinations were normal. D-dimer (610 ng/dL) was slightly elevated. Mismatched subsegmental defects were determined in a ventilation/perfusion scintigraphy. She ceased the hCG injections immediately, and anticoagulant treatment was started, continuing for 3 months, although recovery has been uneventful to date. Literature contains one case in which ischemic stroke and one case in which pulmonary thromboembolism developed during hCG misuse for weight loss. Although it has yet to be proven, similar case reports increase the suspicion that such events are somehow related with HCG. More attention should be paid to this point when encountering such cases, and urgent legal regulations regarding to the misuse of hCG as part of a diet program should be prepared.

Keywords: Pulmonary thromboembolism, human chorionic gonadotropin (hCG), obesity

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Human Koryonik Gonadotropin Yanlýþ Kullanýmý ile Ýliþkili Pulmoner Tromboembolizm: Olgu Sunumu

Hülya Dirol¹, Ayþe Ödemiþ², Tülay Özdemir^1
1Akdeniz Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Anabilim Dalý, Antalya
²Artvin Devlet Hastanesi, Göðüs Hastalýklarý Kliniði, Artvin

Ýnsan koryonik gonadotropin (hCG)’ in obezite tedavisinde etkili olduðuna dair ilk spekülasyonlarýn üzerinden uzun yýllar geçmiþ olmasýna raðmen etkinliði kanýtlanamamýþtýr. Ne yazýk ki, pulmoner tromboembolizm ile komplike olan hCG kötüye kullanýmý ile halen karþýlaþmaktayýz. Öncesinde bilinen bir hastalýðý olmayan 54 yaþýndaki kadýn hasta plöritik göðüs aðrýsý ile polikliniðe baþvurdu. Baþka solunumsal semptomu yoktu. Ýki ay önce kilo vermek için bir beslenme merkezine baþvurmuþ ve 500 kcal / gün diyetle 125 IU / gün subkutan hCG enjeksiyonuna baþlamýþtý. Hasta menopozda olmasýna raðmen enjeksiyonlardan sonra yüzde kýzarýklýk, memede þiþkinlik, minör vajinal kanama gibi þikayetleri geliþmiþti. Vital bulgularý ve fizik muayenesi normaldi. D-dimer (610 ng / dL) deðeri biraz yüksek saptandý. Ventilasyon / perfüzyon sintigrafisinde mismatch subsegmental defektler görüldü. hCG enjeksiyonlarý hemen durduruldu. Antikoagülan tedavi baþlandý. Tedaviye 3 ay devam edildi ve þimdiye kadar sorun yaþanmadý. Kilo kaybý için hCG yanlýþ kullanýmý sýrasýnda geliþen bir iskemik inme ve bir pulmoner tromboembolizm olgusu bildirilmiþtir. Henüz kesin olmasa da benzer olgu raporlarý bu tür olaylarýn bir þekilde HCG ile iliþkili olduðu þüphesini uyandýrmaktadýr. Mevcut olgularla bu noktaya daha fazla dikkat çekilmeli ve acilen hCG'nin diyet programý olarak kötüye kullanýlmasýyla ilgili yasal düzenleme hazýrlanmalýdýr.

Anahtar Kelimeler: Pulmoner tromboembolizm, insan koryonik gonadotropin (hCG), obezite.

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