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Study · Case report or series · n = 1 · 2026

2 results

Newly Detected Atrial Flutter After Enclomiphene Dose Escalation in a Patient With Prior Mitral Valve Repair and Chronic Immune Thrombocytopenia: A Case Report.

Tariq MN, Abdel Halim AT, Evans JA

Cureus15 Aug 2026

PMID42741668 (opens in a new tab)PMCIDPMC13573640 (opens in a new tab)DOI10.7759/cureus.114562 (opens in a new tab)PepBankPUB-42741668
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Summary

Enclomiphene citrate is increasingly prescribed off-label for secondary male hypogonadism, and its cardiovascular safety profile remains poorly characterised. We report a 46-year-old man with a mitral valve repair performed 20 years earlier and chronic immune thrombocytopenia (ITP) in whom atrial flutter was first documented shortly after he inadvertently increased his enclomiphene dose, taking 50 mg daily in place of 25 mg daily. Laboratory evaluation demonstrated chronic thrombocytopenia with a platelet count of 36 × 10⁹/L, while thyroid function, cardiac biomarkers, and electrolytes were normal. Transthoracic echocardiography showed preserved left ventricular systolic function with mild asymmetric left ventricular hypertrophy, mild left atrial enlargement, and mildly reduced right ventricular systolic function. Computed tomography pulmonary angiography (CTPA) excluded pulmonary embolism. Rate control was achieved with metoprolol and diltiazem. Anticoagulation was deferred because of severe thrombocytopenia, and high-dose prednisone was initiated to raise the platelet count before planned anticoagulation and elective cardioversion. Testosterone was elevated at presentation and the arrhythmia was detected soon after the dose increase, but causality cannot be established. The patient had a remote atriotomy and echocardiographic evidence of chronic atrial and ventricular remodelling, a substrate sufficient on its own to sustain macro-reentrant atrial flutter, and earlier asymptomatic or self-limiting episodes could not be excluded. Formal causality assessment using the Naranjo scale placed the association in the possible category only. The case is presented for two reasons: as an illustration of how a hormonal agent should be weighed against a pre-existing structural substrate rather than assumed to be causal, and as an example of the difficulty of balancing thromboembolic and bleeding risk when atrial flutter coexists with severe ITP.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study2

2 results from studies that gave the peptide. 2 results from people.

  1. 01HumanCase report or seriesSafety outcome

    In a man with prior mitral valve repair, atrial flutter was detected after enclomiphene dose escalation, without established causality.

    In plain wordsA man with prior heart surgery had atrial flutter detected after an enclomiphene dose increase. Causality was uncertain.

    Peptide
    Enclomiphene
    Outcome
    Not applicableAtrial flutter
    Study

    n = 1

    Outcome group
    Adverse events · Cardiovascular
    Studied dose
    50 mg daily instead of 25 mg dailyAs given in this study (human).

    Source sentences

    Summary
    We report a 46-year-old man with a mitral valve repair performed 20 years earlier and chronic immune thrombocytopenia (ITP) in whom atrial flutter was first documented shortly after he inadvertently increased his enclomiphene dose, taking 50 mg daily in place of 25 mg daily.
    2 context sentences
    Summary · context
    Testosterone was elevated at presentation and the arrhythmia was detected soon after the dose increase, but causality cannot be established.
    Summary · context
    Formal causality assessment using the Naranjo scale placed the association in the possible category only.
  2. 02HumanCase report or seriesEfficacy outcome

    In a man taking increased enclomiphene doses, testosterone was elevated at presentation.

    In plain wordsTestosterone was elevated in a man who increased his enclomiphene dose.

    Peptide
    Enclomiphene
    Outcome
    IncreaseElevated testosterone at presentation
    Study

    n = 1

    Outcome group
    Sex hormones and fertility · Endocrine and hormones
    Studied dose
    50 mg daily instead of 25 mg dailyAs given in this study (human).

    Source sentences

    Summary
    Testosterone was elevated at presentation and the arrhythmia was detected soon after the dose increase, but causality cannot be established.
    1 context sentence
    Summary · context
    We report a 46-year-old man with a mitral valve repair performed 20 years earlier and chronic immune thrombocytopenia (ITP) in whom atrial flutter was first documented shortly after he inadvertently increased his enclomiphene dose, taking 50 mg daily in place of 25 mg daily.

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Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    21 Oct 2026, 15:58 UTC

    Study results updated

  2. Version 1

    21 Oct 2026, 12:50 UTC

    First added · source update from Europe PMC

Subjects

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