Irregular menstruation induced by thalidomide

WANG Yan-yan; ZHANG Jiang-lin

Abstract：One 28-year-old young female saw a doctor due to left knee joint pain and swelling for three years, low back pain and left hip pain for two years. The patient had left knee joint pain and swelling, low back pain accompanied by morning stiffness and nocturnal back pain, as well as double heel pain. The patient had no history of iritis and family history of the ankylosing spondylitis (AS). HLA-B27 was positive, erythrocyte sedimentation rate was 36 mm·h-1, C-reactive protein was 3.48 mg·dL-1, and sacroiliac joint CT showed bilateral sacroiliac joints erosion change. The patient was diagnosed with AS. Loxoprofen sodium and sulfasalazine were given. The symptom of left hip pain improved after the treatment, but the low back pain did not obviously relieve. Then thalidomide was given orally with the dose of 50 mg every night, and the dose was added to 100 mg after 2 weeks. Four months later, the symptom of low back pain signiifcantly improved, morning stiffness and nocturnal back pain disappeared. But menstrual blood volume of the patient decreased gradually and subsequently the patient developed amenorrhea. Transvaginal ultrasonography showed normal. The symptoms improved after withdrawl of thalidomide for 2 months.