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Pulmonary haemorrhage and extensive arterial thrombosis with anabolic steroid abuse
  1. Angad Singh1,
  2. Anahat Kaur2,
  3. Corbin Stephens1,
  4. Ian Fekete1,
  5. John Nelson1 and
  6. Naresh Kodwani1
  1. 1Internal Medicine, HCA MidAmerica DIvision, Kansas City, Kansas, USA
  2. 2Hematology and Medical Oncology, Albert Einstein College of Medicine D Samuel Gottesman Library, Bronx, New York, USA
  1. Correspondence to Dr Anahat Kaur; dr.anahatkaur{at}


Anabolic-androgenic steroids (AASs) are commonly implicated in thromboembolic events but rarely cause diffuse alveolar haemorrhage. We report the case of a Caucasian man in his late 40s who was consuming supratherapeutic doses of AAS and presented with shortness of breath and haemoptysis. Chest imaging showed bilateral patchy infiltrates in the lungs with diffuse blood throughout the airways on bronchoscopy. Extensive infectious and autoimmune workup were unremarkable. The patient then developed right foot ischaemia and was found to have extensive aortic and bilateral lower extremity arterial thrombosis. Anticoagulation was attempted despite haemoptysis. Thrombectomy procedures were unsuccessful and the patient eventually developed worsening rhabdomyolysis requiring intubation and bilateral amputation. His clinical condition continued to worsen and he passed away 10 days after admission. This case highlights the rare synchronous occurrence of two life-threatening complications secondary to anabolic steroid abuse which can pose a significant diagnostic and therapeutic challenge for clinicians.

  • Toxicology
  • Drugs misuse (including addiction)
  • Respiratory medicine

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AS, AK, CS,IF, JN, NK. The following authors gave final approval of the manuscript:AS, AK, CS, IF,JN and NK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.