title: Recurrent venous thrombosis including cerebral venous sinus thrombosis in a patient taking sildenafil for erectile dysfunction.
abstract: Acquired or hereditary prothrombotic risk factors may lead to cerebral venous sinus thrombosis (CVST), particularly when other predisposing factors coexist. A 57-year-old man experienced right leg deep venous thrombosis, severe thrombosis of the haemorrhoid plexus and CVST over a 12-month period during which he was taking sildenafil regularly twice a week. Sildenafil is a phosphodiesterase 5 (PDE5)-inhibitor used for erectile dysfunction (ED). A slight reduction in antithrombin III and free protein S levels was demonstrated. After suspension of sildenafil and six months on oral anticoagulants, clinical improvement was obtained. Recurrent venous thrombosis, including CVST, may complicate prolonged treatment with PDE5-inhibitors in subjects at risk. Periodic monitoring of clotting factors is recommended in these subjects.
authors.affiliation: Dipartimento di Scienze Neurologiche e del Comportamento, Università di Siena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rufa
authors.forename: A
authors.initials: A
authors.lastname: Cerase
authors.forename: L
authors.initials: L
authors.lastname: Monti
authors.forename: M T
authors.initials: MT
authors.lastname: Dotti
authors.forename: A
authors.initials: A
authors.lastname: Giorgio
authors.forename: F
authors.initials: F
authors.lastname: Sicurelli
authors.forename: A
authors.initials: A
authors.lastname: Federico
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology; D001778:Blood Coagulation Disorders / Q000139:chemically induced / Q000503:physiopathology; D002908:Chronic Disease; D003392:Cranial Sinuses / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D011687:Purines / Q000009:adverse effects; D055502:Secondary Prevention; D000068677:Sildenafil Citrate; D012851:Sinus Thrombosis, Intracranial / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D013450:Sulfones / Q000009:adverse effects*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D000925:Anticoagulants; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate