An unusual finding of massive pulmonary embolism in a patient during treatment with high-dose ibuprofen.
Non-steroidal anti-inflammatory drugs have been associated with an increased risk of venous thromboembolism. We report for the first time, the case of a patient who developed massive pulmonary embolism after a long period of treatment with high doses of ibuprofen. A 65-year-old woman was admitted with severe dyspnea while on treatment with high doses of ibuprofen for diffuse spine pain due to arthrosis. A spiral computed tomography showed a massive pulmonary embolism. No other explanation for the thromboembolic disorder was found. She was successfully treated with therapeutic doses of low-molecular-weight heparin followed by rivaroxaban. Ibuprofen was discontinued and replaced by tramadol. High-dose ibuprofen is likely to have accounted for the life-threatening thromboembolic disorder.
Internal Medicine, Coagulation Section, Cardiovascular Science Department, Padua University, Via Giustiniani, 2, 35128, Padua, Italy. franca.bilora@sanita.padova.it.
Franca
F
Bilora
Internal Medicine, Coagulation Section, Cardiovascular Science Department, Padua University, Via Giustiniani, 2, 35128, Padua, Italy.
Angelo
A
Adamo
Internal Medicine Department (DIMED), Radiology Institute, Padua University, Padua, Italy.
Fabio
F
Pomerri
Internal Medicine, Coagulation Section, Cardiovascular Science Department, Padua University, Via Giustiniani, 2, 35128, Padua, Italy.
Paolo
P
Prandoni
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000009:adverse effects; D000069451:Long Term Adverse Effects / Q000517:prevention & control; D055013:Osteoarthritis, Spine / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D000069552:Rivaroxaban / Q000008:administration & dosage; D036542:Tomography, Spiral Computed / Q000379:methods; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D000069552:Rivaroxaban; D007052:Ibuprofen
Adverse effects; Ibuprofen; Non-steroidal anti-inflammatory; Pulmonary embolism; Venous thromboembolism