title: Pulmonary embolism associated with protein C deficiency and abuse of anabolic-androgen steroids.
abstract: We present the case of a 19-year-old male athlete with protein C deficiency who developed proximal deep venous thrombosis and pulmonary embolism while abusing anabolic-androgenic steroids. Anabolic-androgenic steroids have been reported to have anticoagulatory and profibrinolytic effects in patients with protein C deficiency. Despite these antithrombotic effects, the patient developed repeated venous thromboembolism during treatment with low-molecular-weight heparin. The net effect of anabolic-androgenic steroids on the haemostatic system may change from antithrombotic to prothrombotic in male abusers of anabolic steroids with protein C deficiency.
authors.affiliation: University of Lund, Vascular Center Malmö-Lund, Malmö University Hospital, Malmö, Sweden. Alaa.alhadad@skane.se
authors.forename: Alaa
authors.initials: A
authors.lastname: Alhadad
authors.forename: Stefan
authors.initials: S
authors.lastname: Acosta
authors.forename: Latif
authors.initials: L
authors.lastname: Sarabi
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D017985:Dalteparin / Q000627:therapeutic use; D004300:Doping in Sports; D017984:Enoxaparin / Q000627:therapeutic use; D006408:Hematoma, Subdural / Q000209:etiology; D006801:Humans; D008297:Male; D008696:Methandrostenolone / Q000009:adverse effects*; D010996:Pleural Effusion / Q000209:etiology; D020151:Protein C Deficiency / Q000150:complications* / Q000235:genetics; D011655:Pulmonary Embolism / Q000209:etiology*; D019966:Substance-Related Disorders; D019851:Thrombophilia / Q000139:chemically induced / Q000235:genetics; D013924:Thrombophlebitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D016306:Vena Cava Filters; D014812:Vitamin K / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; D017984:Enoxaparin; D014812:Vitamin K; C025667:prothrombin complex concentrates; D008696:Methandrostenolone; D017985:Dalteparin