title: Mesenteric vein thrombosis caused by secondary polycythaemia from AndroGel.
abstract: Mesenteric vein thrombosis is a rare but potentially lethal cause of abdominal pain. It is usually caused by prothrombotic states that can either be hereditary or acquired. Testosterone supplementation causes an acquired prothrombotic state by promoting erythropoeisis thus causing a secondary polycythaemia. We report a case of a 59-year-old man with a history of chronic obstructive pulmonary disease (COPD) stage III, who presented with abdominal pain. Evaluation revealed an elevated haemoglobin and haematocrit, a superior mesenteric vein thrombosis on CT and a negative Janus kinase 2 mutation. The patient is currently being treated with 6 months of anticoagulation with rivaroxiban. Although a well-known side effect of testosterone is thrombosis, the present case is used to document in the literature the first case of mesenteric vein thrombosis due to secondary polycythaemia from Androgel in the setting of COPD.
authors.affiliation: Department of Internal Medicine, Broward Health Medical Center, Fort Lauderdale, Florida, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Katz
authors.affiliation: Department of Internal Medicine, Broward Health Medical Center, Fort Lauderdale, Florida, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Popov
authors.affiliation: Department of Internal Medicine, Broward Health Medical Center, Fort Lauderdale, Florida, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Bray
authors.affiliation: Department of Hematology/Oncology, Broward Health Medical Center, Fort Lauderdale, Florida, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Berman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology*; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use; D011086:Polycythemia / Q000139:chemically induced* / Q000188:drug therapy; D000069552:Rivaroxaban; D013739:Testosterone / Q000009:adverse effects*; D013876:Thiophenes / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology*
chemical_list: D009025:Morpholines; D013876:Thiophenes; D013739:Testosterone; D000069552:Rivaroxaban