Abstract
Acquired or hereditary prothrombotic risk factors may lead to cerebral venous sinus thrombosis (CVST), particularly when other predisposing factors coexist. A 57-year-old man experienced right leg deep venous thrombosis, severe thrombosis of the haemorrhoid plexus and CVST over a 12-month period during which he was taking sildenafil regularly twice a week. Sildenafil is a phosphodiesterase 5 (PDE5)-inhibitor used for erectile dysfunction (ED). A slight reduction in antithrombin III and free protein S levels was demonstrated. After suspension of sildenafil and six months on oral anticoagulants, clinical improvement was obtained. Recurrent venous thrombosis, including CVST, may complicate prolonged treatment with PDE5-inhibitors in subjects at risk. Periodic monitoring of clotting factors is recommended in these subjects.
MeSH terms
-
Anticoagulants / therapeutic use
-
Blood Coagulation / drug effects
-
Blood Coagulation / physiology
-
Blood Coagulation Disorders / chemically induced
-
Blood Coagulation Disorders / physiopathology
-
Chronic Disease
-
Cranial Sinuses / drug effects
-
Cranial Sinuses / pathology
-
Cranial Sinuses / physiopathology
-
Humans
-
Magnetic Resonance Imaging
-
Male
-
Middle Aged
-
Phosphodiesterase Inhibitors / adverse effects*
-
Piperazines / adverse effects*
-
Purines / adverse effects
-
Secondary Prevention
-
Sildenafil Citrate
-
Sinus Thrombosis, Intracranial / chemically induced*
-
Sinus Thrombosis, Intracranial / pathology
-
Sinus Thrombosis, Intracranial / physiopathology
-
Sulfones / adverse effects*
-
Treatment Outcome
-
Venous Thrombosis / chemically induced*
-
Venous Thrombosis / physiopathology
Substances
-
Anticoagulants
-
Phosphodiesterase Inhibitors
-
Piperazines
-
Purines
-
Sulfones
-
Sildenafil Citrate