Do-It-Yourself Disaster

• Published in: The American journal of medicine Vol. 122; no. 5; pp. 427 - 428
• Main Authors: Connor, Andrew, MBBS, MRCP, Dick, Craig, MD, LRCP, LRCS, LRCPS, FRCR, Bushnell, James, MBChB, MRCP, Taylor, Jo, MD, FRCP
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2009; Elsevier; Elsevier Sequoia S.A
• Subjects: Adult; Angiography; Anticoagulants - therapeutic use; Biological and medical sciences; Diagnosis, Differential; Estrogens; Estrogens - adverse effects; Estrogens - therapeutic use; Follow-Up Studies; General aspects; Gynecomastia - drug therapy; Hormone replacement therapy; Humans; Internal Medicine; Male; Medical diagnosis; Medical disorders; Medical sciences; Physical examinations; Pulmonary Embolism - chemically induced; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - drug therapy; Tomography, X-Ray Computed; Disaster medicine; Disaster
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2008.11.030

Connor et al present a case study wherein a 42-year-old man presented with progressive breathlessness and episodic light-headedness. Gynecomastia was noted on repeat examination the following morning. After further questioning, the patient said that he had been experiencing gender dysphoria since the age of 7 years. He disclosed an 18-month history of self-treatment with varying doses of estrogens. At presentation, he was using transdermal estradiol, 100 mg daily; oral ethinyl estradiol, 30 mcg daily; and oral spironolactone, 200 mg daily in order to deliberately induce feminization. A diagnosis of pulmonary emboli secondary to self-treatment with estrogens was therefore reached.