# Testosterone Therapy as an Isolated Risk Factor for Venous Thrombosis: A Case Report

## TL;DR

A young male patient on testosterone therapy developed severe blood clots, suggesting TRT might be a risk factor for VTE that should be considered in clinical tools.

## Contribution

This case report highlights TRT as a potential risk factor for VTE that is currently not included in clinical decision tools.

## Key findings

- A young male on TRT presented with extensive VTE despite being low risk by standard scoring tools.
- The case suggests a possible link between TRT and increased VTE risk.
- Current VTE risk assessment tools do not account for testosterone therapy.

## Abstract

Healthcare providers in the emergency department (ED) diagnose and treat venous thrombus embolism (VTE). Current VTE clinical decision tools specifically mention estrogen but do not include the use of testosterone replacement therapy (TRT). A male in the early third decade of life presented to the ED with complaints of left calf pain and subjective swelling for one week. The patient was low risk using VTE scoring tools. The patient had multiple occlusive VTE on lower-extremity ultrasound and extensive central, bilateral segmental, and subsegmental pulmonary emboli. He was admitted to the hospital and placed on a heparin drip. TRT may be seen in clinical practice in both male and female patients. This bodes the question of whether TRT should be added to the risk analysis tools used to evaluate and predict the risk for VTE. There have been conflicting reports in research, with more recent studies indicating the risk associated with TRT. This case study demonstrates the risk of VTE with TRT. Further investigation is needed to determine if there is a correlation between VTE and TRT. Clinical decision tools should be updated to include TRT accordingly.