An unusual finding of massive pulmonary embolism in a patient during treatment with high-dose ibuprofen

Aging Clin Exp Res. 2016 Feb;28(1):167-8. doi: 10.1007/s40520-015-0467-4. Epub 2015 Oct 26.

Abstract

Non-steroidal anti-inflammatory drugs have been associated with an increased risk of venous thromboembolism. We report for the first time, the case of a patient who developed massive pulmonary embolism after a long period of treatment with high doses of ibuprofen. A 65-year-old woman was admitted with severe dyspnea while on treatment with high doses of ibuprofen for diffuse spine pain due to arthrosis. A spiral computed tomography showed a massive pulmonary embolism. No other explanation for the thromboembolic disorder was found. She was successfully treated with therapeutic doses of low-molecular-weight heparin followed by rivaroxaban. Ibuprofen was discontinued and replaced by tramadol. High-dose ibuprofen is likely to have accounted for the life-threatening thromboembolic disorder.

Keywords: Adverse effects; Ibuprofen; Non-steroidal anti-inflammatory; Pulmonary embolism; Venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anticoagulants / administration & dosage
  • Female
  • Heparin, Low-Molecular-Weight / administration & dosage*
  • Humans
  • Ibuprofen* / administration & dosage
  • Ibuprofen* / adverse effects
  • Long Term Adverse Effects / prevention & control
  • Osteoarthritis, Spine / drug therapy
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / drug therapy
  • Pulmonary Embolism* / etiology
  • Pulmonary Embolism* / physiopathology
  • Rivaroxaban / administration & dosage
  • Tomography, Spiral Computed / methods
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Rivaroxaban
  • Ibuprofen