Hemothorax after Lupron therapy of a patient with pleural endometriosis--a case report and literature review.
BACKGROUND
Pulmonary endometrial implants, although uncommon, have been well described in the literature. Symptoms occur with menses and may include recurrent pleuritic chest pain, pneumothorax, hemoptysis, or hemothorax. Exacerbation of pulmonary symptoms by Lupron therapy has not been previously described.


METHODS
A 38-year-old African-American female with known endometriosis but no history of pulmonary disease was evaluated for a 2-year history of severe dysmenorrhea. A trial of hormonal suppression was unsuccessful, and she was offered Lupron therapy. Three weeks after its initiation, and shortly after the onset of menses, she came to the emergency room with pleuritic chest pain and shortness of breath and was found to have a right-sided hemopneumothorax. Thoracentesis treatment was successful in eliminating this symptom.


CONCLUSIONS
Although pulmonary endometriosis is rare, physicians should be aware that Lupron therapy can exacerbate pulmonary symptoms during the initial phase of therapy.
Margolis
M T
MT
Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA.
Thoen
L D
LD
Mercer
L J
LJ
Keith
L G
LG
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D006491:Hemothorax / Q000139:chemically induced*; D006801:Humans; D016729:Leuprolide / Q000009:adverse effects* / Q000627:therapeutic use*; D010995:Pleural Diseases / Q000188:drug therapy*
D018931:Antineoplastic Agents, Hormonal; D016729:Leuprolide