ECE2019 ePoster Presentations Reproductive Endocrinology (14 abstracts)
Severe pulmonary tromboembolism and klinefelter syndrome
Julia Silva Fernández 1 , Alberto Escalera Zalvide 2 , Francisco Javier Gómez Alfonso 1 , Florentino Del Val Zaballos 1 , Belvis Torres Arroyo 1 , Paloma González Lazaro 1 , Cristina Contreras Pascual 1 , Cristina Montalban Mendez 1 , Alvaro Garcia Manzanares 1 & Inés Gómez García 1
1Endocrinology Department. Mancha Centro General Hospital, Alcázar de San Juan, Spain; 2Department of Internal Medicine. Mancha Centro General Hospital, Alcázar de San Juan, Spain.
Introduction: Klinefelter syndrome (KS) is the most common congenital abnormality causing primary hypogonadism. KS has a tendency for hypercoagulability.
Case report: A 48 year old man diagnosed as having KS during the sterility test was admitted to our hospital emergency department after suffering a syncopal episode at work. He complained of difficulty breathing during the last two weeks and he was receiving bronchodilator therapy. He had suffered deep vein thrombosis in 2014 with normal hypercoagulability workup. At the emergency room his blood pressure and pulse were 116/75 mm Hg and 76 rpm. Phisycal exam reveal no sings of deep vein thrombosis (DVT). Electrocardiography revealed findings of ST depression in V1 V3 areas. The results of arterial blood gas analysis showed hypoxemia (pO2 68, pCO 33, bicarbonate 28, pH 7.4). With the suspicion of possible pulmonary tromboesbolism, contrast enhanced chest computed tomography was carried out which show up submassive pulmonary embolism. Vascular ultrasound of inferior limbs did not find DVT. The patient was transferred to the intensive unit care where he underwent anticoagulation therapy with low molecular weight heparin and warfarin. A complete work up for thrombophilia was made again with normal results. After the patient was discharged from the hospital, he was put on warfarin for anticoagulation therapy and followed up on a outpatient basis.
Conclusions: KS is associated with high risk for venous tromboembolism (VTE). Given the increased incidence of VTE in KS, in patients with dynpnea, Pulmonary thromboembolism must be considered. KS could be considered to be a genetic hypercoagulable state per se. This has clinical implications for the prevention and diagnosis of VTE among patients with KS. We suggest thrombophilia screening in men with KS before starting hormonal treatment.
Volume 63
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Endocrine Abstracts
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