Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지

Pulmonary Thromboembolism after Post-menopause Hormonal Replacement Therapy

폐경기 호르몬 대체요법 후 발생한 폐 색전증

  • 김선영 (인제대학교 의과대학 내과학교실) ;
  • 박종혁 (인제대학교 의과대학 내과학교실) ;
  • 이현경 (인제대학교 의과대학 내과학교실) ;
  • 이혁표 (인제대학교 의과대학 내과학교실) ;
  • 이혜경 (인제대학교 의과대학 병리학교실) ;
  • 최수전 (인제대학교 의과대학 내과학교실) ;
  • 염호기 (인제대학교 의과대학 내과학교실)
  • Received : 2007.08.07
  • Accepted : 2007.10.04
  • Published : 2007.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Hormonal replacement therapy (HRT) has been proven for treatment of postmenopausal symptoms such as hot flushes, night sweats and urologic symptoms. HRT became very popular in the 1990's, when there were several reports showing that it also helped with other menopausal complications such as osteoporosis and cardiovascular disease. Recent studies report that the incidence of breast cancer, endometrial cancer, cerebral infarction, coronary artery diseases, deep vein thrombosis and pulmonary thrombembolism could rise after HRT. Among these side effects of HRT, the risk of pulmonary thromboembolism increases 2 to 4 fold after HRT, but can vary with the use of different doses and preparations. Here, we summarize the risk factors and clinical courses for 5 patients who developed pulmonary thromboembolism after postmenopausal HRT.

폐경기 여성에서 호르몬 대체요법은 폐경기 증상의 경감, 골다공증에 의한 골절, 대장암의 위험도 감소 등의 효과가 인정되어 왔다. 현재도 많은 폐경기 여성에게 사용되어지고 있는 치료법이다. 그러나 그에 따른 부작용 또한 점차 밝혀지며 연구 되고 있다. 이러한 부작용 중 생명을 위협 할 수 있는 폐색전증은 호르몬요법을 사용할시 항상 각별한 주의를 요한다. 폐경기 호르몬대체요법이 필요할 경우 심부정맥혈전증과 폐색전증의 다른 위험인자나 환경적 요인 등을 가진 환자에게 그 사용에 있어 더욱 주위를 기울여야 한다. 또한 폐색전증의 가장 많은 증상인 호흡기 증상이 있을 경우 즉시 적절한 평가와 치료가 필요하다.

Keywords

References

  1. Daly E, Vessey MP, Hawkins MM, Carson JL, Gough P, Marsh S. Risk of venous thromboembolism in users of hormone replacement therapy. Lancet 1996;348:977-80 https://doi.org/10.1016/S0140-6736(96)07113-9
  2. Douketis JD, Julian JA, Keamn C, Anderson DR, Crowther MA, Bates SM, et al. The, the type of hormone replacement therapy influence the risk of deep vein thrombosis? A prospective case-control study. J Thromh Haemost 2005;3:943-8 https://doi.org/10.1111/j.1538-7836.2005.01268.x
  3. Nelson HD, Humphrey LL, Nygren P, Teutsch SM, Allan JD. Postmenopausal hormone replacement therapy. JAMA 2002;288:872-81 https://doi.org/10.1001/jama.288.7.872
  4. Bae SJ, Kim JS, Kim JH, Yun YJ, Lee SA A case of venous thrombosis developed in a woman taking oral contraceptives with antithrombin III, protein C and protein 8 deficiencies. Korean J Obstet Gynecol 2003;49:1383-8
  5. Scarahin PY, Oger E, Plu-Bureau G. Differential association of oral and transderkmal oestmgen-replacement therapy with venous thromboemholism risk. Lancet 2003;362:428-32 https://doi.org/10.1016/S0140-6736(03)14066-4
  6. Barlow DH. Hormone replacement therapy and the risk of deep vein thrombosis. Int J Gynecol Obstet 1997;59:S29-S33 https://doi.org/10.1016/S0020-7292(97)90196-X
  7. Wu O. Pbstmenopausal hormone replacement therapy and venous thromboembolism. Gender Medicine 2005;2:S18-S27 https://doi.org/10.1016/S1550-8579(05)80061-0
  8. Lidegaard O, Edstrim B, Kreiner S. Oral contraceptives and venous thromboemholism. A case-control study. Contraception 1998;57:291-301 https://doi.org/10.1016/S0010-7824(98)00033-X
  9. Vessay M, Mant D, Smith A, Yeates D. Oral contraceptives and venous thromboemholism: findings in a large prospective study. Br Med J 1983;292:526 https://doi.org/10.1136/bmj.292.6519.526
  10. Gerstman BB, Piper JM, Freiman JP, Tomita DR, Kennedy DL, Ferguson WJ, et al. Oral contruceptive estrogen and progestin potencies and the incidence of deep venous thromboembolism. Int J Epidemiol 1990;19:931-6 https://doi.org/10.1093/ije/19.4.931
  11. Gerstman EB, Piper JJM, Tomita DK, Ferguoon WJ, Stadel BV, Lundin FE. Oral contraceptive estrogen dose and the risk of deep venous thromboembolic disease. Am J Epidemiol 1991;133:32-7 https://doi.org/10.1093/oxfordjournals.aje.a115799
  12. Jick H, Derby LE, Myers MW, Vasi!akis C, Newton KM. Risk of hospital admission for idiopathic venous thromboembolism among users of postmenopausal oestrogens. Lancet 1993;348:931-3