{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:12:24Z","timestamp":1777479144414,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2013,4,23]],"date-time":"2013-04-23T00:00:00Z","timestamp":1366675200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:p>We describe thrombosis, deep venous thrombosis (DVT) pulmonary embolism (PE; n = 9) and hip-knee osteonecrosis (n = 5) that developed after testosterone therapy (median 11 months) in 14 previously healthy patients (13 men and 1 woman; 13 Caucasian and 1 African American), with no antecedent thrombosis and previously undiagnosed thrombophilia\u2013hypofibrinolysis. Of the 14 patients, 3 were found to be factor V Leiden heterozygotes, 3 had high factor VIII, 3 had plasminogen activator inhibitor 1 4G4G homozygosity, 2 had high factor XI, 2 had high homocysteine, 1 had low antithrombin III, 1 had the lupus anticoagulant, 1 had high anticardiolipin antibody Immunoglobulin G, and 1 had no clotting abnormalities. In 4 men with thrombophilia, DVT-PE recurred when testosterone was continued despite therapeutic international normalized ratio on warfarin. In 60 men on testosterone, 20 (33%) had high estradiol (E2 &gt;42.6 pg\/mL). When exogenous testosterone is aromatized to E2, and E2-induced thrombophilia is superimposed on thrombophilia\u2013hypofibrinolysis, thrombosis occurs. The DVT-PE and osteonecrosis after starting testosterone are associated with previously undiagnosed thrombophilia\u2013hypofibrinolysis. Thrombophilia should be ruled out before administration of exogenous testosterone.<\/jats:p>","DOI":"10.1177\/1076029613485154","type":"journal-article","created":{"date-parts":[[2013,4,24]],"date-time":"2013-04-24T20:34:31Z","timestamp":1366835671000},"page":"22-30","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Testosterone, Thrombophilia, and Thrombosis"],"prefix":"10.1177","volume":"20","author":[{"given":"Charles J.","family":"Glueck","sequence":"first","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin","family":"Richardson-Royer","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reiker","family":"Schultz","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"},{"name":"The Internal Medical Residency Program, Jewish Hospital of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Burger","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"},{"name":"The Internal Medical Residency Program, Jewish Hospital of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanta","family":"Labitue","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"},{"name":"The Internal Medical Residency Program, Jewish Hospital of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad K.","family":"Riaz","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"},{"name":"The Internal Medical Residency Program, Jewish Hospital of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jagjit","family":"Padda","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"},{"name":"The Internal Medical Residency Program, Jewish Hospital of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dedrick","family":"Bowe","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"},{"name":"The Internal Medical Residency Program, Jewish Hospital of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naila","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"The Jewish Hospital Cholesterol Center, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,4,23]]},"reference":[{"key":"bibr1-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2011.06.003"},{"key":"bibr2-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1080\/tam.5.2.98.102"},{"key":"bibr3-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000149639.25136.CA"},{"key":"bibr4-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.639"},{"key":"bibr5-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00467.2005"},{"key":"bibr6-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000254473.88647.ca"},{"key":"bibr7-1076029613485154","first-page":"103","volume":"55","author":"Hedlund PO","year":"1980","journal-title":"Scand J Urol Nephrol Suppl"},{"key":"bibr8-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030520"},{"key":"bibr9-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0148-0"},{"key":"bibr10-1076029613485154","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200412000-00009"},{"key":"bibr11-1076029613485154","author":"Glueck CJ","year":"2012","journal-title":"Clin Appl Thromb Hemost"},{"key":"bibr12-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-08-0888"},{"key":"bibr13-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1614564"},{"key":"bibr14-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1177\/107602960501100404"},{"key":"bibr15-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2005.04.024"},{"key":"bibr16-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(93)90042-M"},{"key":"bibr17-1076029613485154","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200105000-00004"},{"key":"bibr18-1076029613485154","unstructured":"GmbH RD. 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