Sun W, Liao JP, Hu Y, Zhang W, Ma J, Wang GF. Pulmonary embolism and deep vein thrombosis caused by nitrous oxide abuse: A case report. World J Clin Cases 2019; 7(23): 4057-4062 [PMID: 31832409 DOI: 10.12998/wjcc.v7.i23.4057]
Corresponding Author of This Article
Ji-Ping Liao, MD, Professor, Associate Chief, Department of Pulmonary and Critical Care Medicine, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing 100034, China. jipingliao@hotmail.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2019; 7(23): 4057-4062 Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4057
Pulmonary embolism and deep vein thrombosis caused by nitrous oxide abuse: A case report
Wen Sun, Ji-Ping Liao, Yan Hu, Wei Zhang, Jing Ma, Guang-Fa Wang
Wen Sun, Ji-Ping Liao, Yan Hu, Wei Zhang, Jing Ma, Guang-Fa Wang Department of Pulmonary and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China
Author contributions: All authors contributed to the acquisition of data and the writing and revision of the manuscript.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ji-Ping Liao, MD, Professor, Associate Chief, Department of Pulmonary and Critical Care Medicine, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing 100034, China. jipingliao@hotmail.com
Telephone: +86-10-83575753 Fax: +86-10-66551208
Received: August 16, 2019 Peer-review started: August 16, 2019 First decision: October 24, 2019 Revised: November 4, 2019 Accepted: November 14, 2019 Article in press: November 14, 2019 Published online: December 6, 2019 Processing time: 112 Days and 8.9 Hours
Abstract
BACKGROUND
Nitrous oxide (N2O) has gained increasing popularity as a recreational drug, causing hallucinations, excitation, and psychological dependence. However, side effects have been reported in recent years. Our case report proposes a correlation among N2O, pulmonary embolism (PE), and deep vein thrombosis (DVT) and emphasizes the role of homocysteine (Hcy) in thrombotic events.
CASE SUMMARY
A 29-year-old man with long-term N2O abuse sought evaluation after acute chest pain. A diagnostic workup revealed PE, DVT, and hyperhomocysteinemia. The patient was successfully treated with thrombolytic and anticoagulant therapy. Moreover, his Hcy level decreased and returned to normal after Hcy-lowering therapy.
CONCLUSION
Chronic N2O abuse might increase the risk of PE and DVT, although there have been few studies previously.
Core tip: Pulmonary embolism and deep vein thrombosis arising from nitrous oxide use are extremely rare, although the mechanism seems reasonable, and few cases have been reported. In this case, chronic nitrous oxide abuse might be a direct or an indirect factor contributing to pulmonary embolism and deep vein thrombosis. Moreover, the treatment is unknown, and the prognosis is uncertain. Thus, we report this rare case and include a detailed discussion.
