TITLE:
Oral Phosphodiesterase Type 5 Inhibitors in Recurrent Priapism Complicating Thalassemia Intermedia: A Case Report
AUTHORS:
Davood Maleki
KEYWORDS:
PDE5is, Reccurent Priapism, Thalassemia Intermedia, PDE5is for Priapism, Gonadotropin-Releasing Hormone Agonist for Priapism
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.3 No.6,
June
5,
2014
ABSTRACT: Recurrent priapism
is a rare, serious and difficult to treat complication of some hematological
disorders, for which no standard therapy exists. This study reports a case of a
42-year-old man with thalassemia intermedia complicated by recurrent episodes
of priapism. To prevent priapism recurrences, a trial of PDE5is use was
initiated. One day after initiation of a PDE5i (25 mg sildenafil repeated every
8 hours), priapism was improved. For 3 weeks, the patient reported improvement,
without experiencing any episodes of priapism and a normal physiologic erectile
function. Four weeks after treatment he experienced priapism reoccurrence and
doubling of the Sildenafil was not effective. Gonadotropin-releasing hormone
agonist initiated and one week after initiatin of new drug he improved. He was
free of priapism episodes for more than 2 years afterward. PDE5 deregulation
seems to be an underling pathologic mechanism of recurrent priapism at least in
thalassemia intermedia patients. It appears that PDE5is may have a role in the
management of such patients and further testing in clinical trials is needed.