leuprolide and Acute-Disease

Topics: Acute Disease; Adolescent; Adult; Antineoplastic Agents, Hormonal; Female; Humans; Leukemia; Leuprolide; Menorrhagia

Subclinical and clinical thrombosis of bioprosthetic cardiac valves is more common than has been previously recognized. We present a unique case of acute thrombosis of a bioprosthetic mitral valve in a 40-year-old female patient undergoing hormonal stimulation as part of in vitro fertilization therapy, who also had concomitant protein C deficiency that was undiagnosed at the time. To the best of our knowledge, this is the first reported case of acute bioprosthetic valve thrombosis in this complex thrombophilic milieu, and suggests the need for increased screening for prothrombotic risk factors in female patients with bioprosthetic valves before they commence gonadotropin stimulation therapy.

Topics: Acute Disease; Adult; Bioprosthesis; Female; Fertility Agents, Female; Fertilization in Vitro; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Leuprolide; Mitral Valve; Protein C Deficiency; Reoperation; Risk Factors; Thrombosis

Gonadotropin-releasing hormone (GnRH) agonists have been used for the treatment of various diseases. Although autoimmune thyroid disease has been reported as a rare complication of these agents, the symptoms are almost always transient and non-life-threatening. We herein report a rare case of an 83-year-old man receiving GnRH agonist treatment for prostate cancer who developed myxedema coma complicated by acute pancreatitis. This is the first report of myxedema coma potentially associated with a GnRH agonist. The follow-up of the thyroid function is necessary for patients undergoing treatment with GnRH agonists, especially those known to have or to be susceptible to autoimmune thyroid disease.

Topics: Acute Disease; Aged, 80 and over; Antineoplastic Agents, Hormonal; Coma; Gonadotropin-Releasing Hormone; Humans; Leuprolide; Male; Myxedema; Pancreatitis; Prostatic Neoplasms

Topics: Acute Disease; Adolescent; Adult; Antineoplastic Agents, Hormonal; Drug Evaluation; Female; Humans; Leukemia; Leuprolide; Menstruation; Ovulation; Primary Ovarian Insufficiency; Retrospective Studies

Hormone therapy with leuprolide acetate (Lupron) is frequently used to treat prostate cancer, a common malignancy expected to be diagnosed in >180,000 men in the United States this year. In addition, testosterone supplementation is frequently recommended for adult men with reduced libido or impotence and decreased serum levels of testosterone. Although these hormone therapies are generally considered benign, we describe 3 cases of acute cardiac rejection temporally associated with the use of these drugs in men who have undergone cardiac transplantation. To our knowledge, this is the first such description of this phenomenon in the literature.

Topics: Acute Disease; Adenocarcinoma; Aged; Graft Rejection; Heart Transplantation; Hormone Replacement Therapy; Humans; Leuprolide; Male; Middle Aged; Prostatic Neoplasms; Risk Factors; Stroke Volume; Testosterone; United States; Ventricular Function, Left

The syndrome of pituitary apoplexy has been reported to occur after the administration of several different medications. We report a case in which pituitary apoplexy developed shortly after the administration of leuprolide in a patient with prostate cancer. Leuprolide is a potent gonadotrophin releasing hormone (GnRH) analogue used to suppress leuteotrophic hormone (LH) and testosterone levels in patients with metastatic prostate cancer. LH and testosterone levels actually rise in the first week after its administration before becoming suppressed. We suspect that this acute stimulating effect of leuprolide is linked to the acute onset of pituitary apoplexy in a patient with a possible gonadotrophoma.

Topics: Acute Disease; Aged; Antineoplastic Agents, Hormonal; Gonadotropin-Releasing Hormone; Humans; Leuprolide; Magnetic Resonance Imaging; Male; Pituitary Apoplexy; Pituitary Gland; Prostatic Neoplasms; Tomography, X-Ray Computed

A case of rapid uterine enlargement and subsequent urinary retention occurring 7 days after GnRH-a administration in a 53-year-old premenopausal woman with myomas is presented. Rapid uterine enlargement was presumed to be caused by hyperestrogenism shortly after GnRH-a administration. The patient was treated with an indwelling Foley catheter for 2 weeks until the uterus decreased to near baseline dimensions. The patient's uterus continued to decrease in size during the 12 weeks she received GnRH-a, and she underwent an uneventful total abdominal hysterectomy and bilateral salpingectomy/oophorectomy after donating 2 units of autologous blood. This case illustrates that adverse effects from GnRH-a treatment may be caused by the transient increase in ovarian steroid secretion shortly after drug administration.

Topics: Acute Disease; Female; Humans; Leiomyoma; Leuprolide; Middle Aged; Urinary Retention; Uterine Neoplasms; Uterus

Acute vaginal bleeding secondary to uterine myomas can be a devastating event. We report the use of a combined therapeutic approach in a patient who presented with protracted bleeding of a myomatous uterus that was equivalent in size to a 38 week gestation. This patient's course was further complicated by her refusal of blood or blood products.

Topics: Acute Disease; Adult; Anemia; Combined Modality Therapy; Contraceptives, Oral, Synthetic; Drug Therapy, Combination; Estrogens, Conjugated (USP); Female; Hematocrit; Humans; Injections, Subcutaneous; Leiomyoma; Leuprolide; Preoperative Care; Tampons, Surgical; Time Factors; Treatment Refusal; Uterine Hemorrhage; Uterine Neoplasms