Reactions 1494, p11 - 29 Mar 2014

SAspirin/prasugrel

Spontaneous haemorrhage into a thyroid cyst: casereport

A 55-year-old man developed a spontaneous haemorrhageinto a thyroid cyst while receiving antiplatelet therapy withaspirin and prasugrel [routes not stated].

The man underwent placement of a tacrolimus-eluting stent[Taxus] following an inferior myocardial infarction. He beganreceiving aspirin 100 mg/day and prasugrel 10 mg/day. Twodays later, he developed new-onset dysphagia and aworsening sore throat, followed a few hours later byprogressive swelling of the left cervical region. A neck CTrevealed an intrathyroideal haematoma measuring13 × 7 ×6mm, causing compression of the trachea andoesophagus.

The man was intubated and underwent an immediate lefthemithyroidectomy with decompression of the haematoma.His postoperative recovery was quick, and histologicalfindings revealed no evidence of malignancy.

Author comment: "[The patient developed] a spontaneoushaemorrhage into a thyroid cyst under aspirin andprasugrel. . . [T]he faster and more effective platelet inhibitionobtained by prasugrel may lead to an increased risk of majorand even atypical bleeding events after previous fibrinolytictherapy."Wiedemann S, et al. Acute dysphagia after myocardial infarction: An unusualcomplication of anticoagulation therapy. Kardiologia Polska 72: 87, No. 1, Jan2014 - Germany 803100940

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Reactions 29 Mar 2014 No. 14940114-9954/14/1494-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved