Endometrial hyperplasia and severe anemia induced by toremifene
10.3760/cma.j.cn114015-20240719-00612
- VernacularTitle:托瑞米芬致子宫内膜增生合并重度贫血
- Author:
Bao LI
1
;
Jie LI
;
Xiubo SUN
;
Ling YU
Author Information
1. 吉林大学第二医院药学部，长春 130041
- Publication Type:Journal Article
- Keywords:
Endometrial hyperplasia;
Toremifene;
Uterine hemorrhage;
Selective estrogen receptor modulators;
Breast neoplasms;
Severe anemia
- From:
Adverse Drug Reactions Journal
2025;27(5):318-320
- CountryChina
- Language:Chinese
-
Abstract:
A 42-year-old female patient received toremifene 60 mg orally once daily for 5 years after breast cancer surgery. She had a regular menstrual cycle and no history of abnormal bleeding. For more than 1 month, she experienced irregular vaginal bleeding, which worsened for 3 days. The transvaginal color doppler ultrasound revealed endometrial thickening, and laboratory tests showed red blood cell count 1.8×10 12/L and hemoglobin 35 g/L. The clinical diagnosis was abnormal uterine bleeding, endometrial thickening, and severe anemia. Symptomatic and supportive treatments, such as hemocoagulase, human erythropoietin, oxytocin, cefuroxime, and blood transfusion were given immediately. Civen the suspicion that toremifene-induced endometrial hyperplasia was the cause of abnormal uterine bleeding, toremifene was discontinued the following day. The symptomatic treatments (including blood transfusion) were continued, and iron supplementation was given. On the third day after discontinuation of toremifene, the patient underwent diagnostic hysteroscopic curettage. The postoperative pathological examination showed endometrial hyperplasia. The next day, the patient had no significant vaginal bleeding, with red blood cell count 3.6×10 12/L and hemoglobin 93 g/L. Reexamination at 4 weeks revealed red blood cell count 4.3×10 12/L and hemoglobin 135 g/L.
