Assuntos
Eritema Nodoso/tratamento farmacológico , Hanseníase Virchowiana/tratamento farmacológico , Embolia Pulmonar/induzido quimicamente , Talidomida/efeitos adversos , Trombose Venosa/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Eletrocardiografia , Eritema Nodoso/complicações , Humanos , Hanseníase Virchowiana/complicações , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico por imagem , Taquipneia/etiologia , Trombose Venosa/tratamento farmacológicoRESUMO
A 58-year-old Japanese man with a 2-year history of multidrug therapy for borderline lepromatous leprosy presented with skin lesions suggestive of erythema nodosum leprosum (ENL) and was treated with an oral corticosteroid. As attempts to taper the oral corticosteroid resulted in the appearance of new lesions, thalidomide was added along with cyclosporin. Two months after the introduction of thalidomide, deep venous thrombosis (DVT) occurred in both legs and anticoagulant therapy was started without cessation of thalidomide. Pulmonary embolism developed 1 month after the appearance of DVT, and these thromboembolic events were believed to be due to thalidomide. This case highlights the need for vigilance against venous thromboembolism when corticosteroid and thalidomide are co-administrated for the treatment of ENL.