title: Deep venous thrombosis and pulmonary embolism secondary to co-administration of thalidomide and oral corticosteroid in a patient with leprosy.
abstract: A 58-year-old Japanese man with a 2-year history of multidrug therapy for borderline lepromatous leprosy presented with skin lesions suggestive of erythema nodosum leprosum (ENL) and was treated with an oral corticosteroid. As attempts to taper the oral corticosteroid resulted in the appearance of new lesions, thalidomide was added along with cyclosporin. Two months after the introduction of thalidomide, deep venous thrombosis (DVT) occurred in both legs and anticoagulant therapy was started without cessation of thalidomide. Pulmonary embolism developed 1 month after the appearance of DVT, and these thromboembolic events were believed to be due to thalidomide. This case highlights the need for vigilance against venous thromboembolism when corticosteroid and thalidomide are co-administrated for the treatment of ENL.
authors.affiliation: Department of Dermatology, Graduate School of Medicine, University of the Ryukyus, Nishihara Chuo Dermatological Office, Naha, Okinawa, Japan. toyosayahotmail@hotmail.co.jp
authors.forename: Sayaka
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hosokawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hagiwara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uezato
authors.forename: Kenzo
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007918:Leprosy / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D007917:Leprostatic Agents; D013792:Thalidomide; D014859:Warfarin; D016572:Cyclosporine