Stroke caused by small vessel occlusion in a patient taking etoricoxib and thalidomide.
We report a 33-year-old man with seronegative arthritis who had an acute infarct at the left lentiform nucleus while taking etoricoxib and thalidomide regularly. Extensive investigations did not find any evidence of large artery atherosclerosis, vasculitis, cardioembolic source or anti-phospholipid antibodies. While it is possible that a short smoking history, hyperlipidemia, and the use of thalidomide could have contributed to the thrombosis of a small penetrator vessel, we postulated that the prolonged use of etoricoxib is another possible contributing factor.
Wong
Edward H C
EH
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR. wongeddie@i-cable.com
Leung
Thomas W H
TW
Wong
K S Lawrence
KS
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D002544:Cerebral Infarction / Q000139:chemically induced*; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D000077613:Etoricoxib; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D020767:Intracranial Thrombosis / Q000139:chemically induced*; D008297:Male; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*; D013450:Sulfones / Q000008:administration & dosage / Q000009:adverse effects*; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects*
D052246:Cyclooxygenase 2 Inhibitors; D007166:Immunosuppressive Agents; D011725:Pyridines; D013450:Sulfones; D013792:Thalidomide; D000077613:Etoricoxib