title: Thrombophilia in 67 Patients With Thrombotic Events After Starting Testosterone Therapy.
abstract: We compared thrombophilia in 67 cases (59 men and 8 women) with thrombotic events after starting testosterone therapy (TT) versus 111 patient controls having unprovoked venous thrombotic events without TT. In the 67 patients, thrombosis (47 deep venous thrombosis-pulmonary embolism, 16 osteonecrosis, and 4 ocular thrombosis) occurred 6 months (median) after starting TT. Cases differed from controls for factor V Leiden heterozygosity (16 of the 67 [24%] vs 13 [12%] of the 111, P = .038) and for lupus anticoagulant (9 [14%] of the 64 vs 4 [4%] of the 106, P = .019). After a first thrombotic event and continuing TT, 11 cases had a second thrombotic event, despite adequate anticoagulation, 6 of whom, still anticoagulated, had a third thrombosis. Screening for thrombophilia before starting TT should identify men and women at high risk for thrombotic events with an adverse risk-benefit ratio for TT. When TT is given to patients with familial and acquired thrombophilia, thrombosis may occur and recur in thrombophilic men despite anticoagulation.
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA cjglueck@mercy.com.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Glueck
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
authors.forename: Marloe
authors.initials: M
authors.lastname: Prince
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
authors.forename: Niravkumar
authors.initials: N
authors.lastname: Patel
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
authors.forename: Jaykumar
authors.initials: J
authors.lastname: Patel
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
authors.forename: Parth
authors.initials: P
authors.lastname: Shah
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
authors.forename: Nishi
authors.initials: N
authors.lastname: Mehta
authors.affiliation: Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013739:Testosterone / Q000009:adverse effects* / Q000627:therapeutic use; D019851:Thrombophilia / Q000150:complications / Q000188:drug therapy*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000209:etiology
chemical_list: D016682:Lupus Coagulation Inhibitor; D013739:Testosterone; D005165:Factor V
keywords: anticoagulation; deep venous thrombosis; estradiol; factor V Leiden; human chorionic gonadotropin; lupus anticoagulant; pulmonary embolus; testosterone; venous thromboembolism