Menorrhagia, Tranexamic Acid and False Negative D-Dimer in Patients with Venous Thromboembolism Case Report and Systematic Literature Review.
Loading...
Date
2014-11-11
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
A 56 years-old woman came to our attention for abrupt onset of shortness of breath.
Pulmonary embolism was firstly ruled out due to negative D-Dimer and unlikely probability.
On second day, the patient presented with heavy menorrhagia and treated with
tranexamic acid (TA). She informed that similar episode happened some months ago, so
she had been treated with cycles of TA, discontinued the last time few days before the
hospital admission. After three days from oral intake of TA, the patient suffered from
abrupt painful left calf without any cardiac or respiratory sign. Urgent legs ultrasonography
showed distal deep vein thrombosis and this time a new D-Dimer assay showed a mild
positivity. The patient underwent to computer tomography pulmonary angiography which
revealed bilateral segmental pulmonary embolism. Other three case reports referred to
patients with acute venous thromboembolism after taking TA for menorrhagia emergedfrom systematic review of literature. Two of them presented with false negative D-Dimer.
In another one D-Dimer assay was positive but performed after cardiopulmonary
resuscitation.
TA could link with venous thromboembolism both influencing D-Dimer value, proving false
negativity, and increasing the thrombotic risk in young-adult females suffering from
menorrhagia. These possibilities should be taken into account in this population.
Description
Keywords
Menorrhagia, tranexamic acid, deep vein thrombosis, pulmonary embolism, D-Dimer, diagnosis
Citation
Lorenzini Gianni, Masotti Luca, Ubaldi Euro, Mannucci Annalisa, Bellizzi Annamaria, Bini Chiara, Gori Sandra, Fenu Patrizia, Cannistraro Daniela , Pampana Alessandro. Menorrhagia, Tranexamic Acid and False Negative D-Dimer in Patients with Venous Thromboembolism Case Report and Systematic Literature Review.British Journal of Medicine and Medical Research. 2014 Nov; 4(32): 5116-5124.