黄体ホルモン剤によると思われる下肢静脈血栓・肺塞栓症の1例

A Case of Phlebothrombosis of Lower Extremity and Pulmonary Embolism Due to Progesterone

　Progesteroneによると思われた下肢静脈血栓・肺塞栓症の1例を経験したので報告する．症例は64歳女性で，1967年に右側乳癌の手術をうけた．1989年6月に右肩の上に腫瘤ができ，生検で乳癌の再発と診断された．5-FUなどの抗癌剤の投与により寛解し，8月よりMedroxyprogesterone　acetate 1,200mg／日とTamoxifen 30mg／日が投与された．12月より左下肢の腫脹と息切れが出現し入院した．入院時PO₂67mmHg,PCO₂34mmHgで，血液凝固を示すTATが高値で，血管造影で左下肢静脈と右側肺動脈の閉塞を認め，静脈血栓・肺塞栓症と診断した．乳癌は寛解していた．これらの薬剤を中止後に血栓塞栓症は軽快した．Medroxyprogesterone acetateによる血栓塞栓症と考えられた．

A case with lower extremity phlebothrombosis and pulmonary embobolism caused by progesterone is repor-ted in this paper.

The patient is a 64-year-old woman who had been operated on for right breast cancer 22 years before. It was noticed that there was a relapsing cancer on her right shoulder 6 months before this episode. After effective treatment of 5-FU, she had received 1,200mg of Medroxyprogesterone acetate and 30mg of Tamox-ifen daily for 4 months. With the complaint of dyspnea and left leg swelling 4 months after above treatment, she was admitted in our hospital.