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Case Reports
. 2022 Sep 6;10(25):9142-9147.
doi: 10.12998/wjcc.v10.i25.9142.

Tamsulosin-induced life-threatening hypotension in a patient with spinal cord injury: A case report

Jae Young Lee  1 , Ho Seok Lee  1 , Si-Bog Park  1 , Kyu Hoon Lee  2
Affiliations
Case Reports

Tamsulosin-induced life-threatening hypotension in a patient with spinal cord injury: A case report

Jae Young Lee et al. World J Clin Cases. .

Abstract

Background: Tamsulosin, a selective α1-adrenergic receptor antagonist, is commonly used for treating neurogenic bladder in patients with spinal cord injury (SCI). No severe adverse events have been described with such tamsulosin use. To our knowledge, we report the first case of severe life-threatening hypotension as an adverse effect of tamsulosin in a person with SCI. Therefore, we report this case to inform that this severe adverse effect of tamsulosin can occur when treating patients with SCI.

Case summary: A 59-year-old woman was diagnosed with cervical spinal cord myelopathy and was classified as American Spinal Injury Association Impairment Scale D, neurological level of injury C3. Because she suffered from voiding difficulty due to neurogenic bladder, we prescribed tamsulosin. Her vital signs remained stable, but occasional hypotensive symptoms followed defecation. We reduced the dose of tamsulosin, but after administering tamsulosin for 9 d, she experienced life-threatening hypotension with no evidence of hypovolemic shock, neurogenic shock, cardiogenic shock, or septic shock. A hypotensive condition induced by tamsulosin was the suspected cause, and her symptoms could be associated with adverse effects of tamsulosin. As symptoms resolved after stopping tamsulosin, and no other reason was found, we concluded that tamsulosin was the cause of her symptoms.

Conclusion: Caution for severe hypotension is needed when administering tamsulosin for neurogenic bladder in a patient with SCI.

Keywords: Case report; Hypotension; Neurogenic bladder; Spinal cord injury; Tamsulosin; Vasovagal symptoms.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Cervical spine magnetic resonance imaging findings at admission. A: T2 sagittal image. Cord signal changes at C4-C6 levels were observed; B: T2 axial image at C4 level. Cord signal changes at C4 level are shown; C: T2 axial image at C5 level. Cord signal changes at C5 level and possible hematoma were observed; D: T2 axial image at C6 level. Cord signal changes at C6 level are shown.
Figure 2
Figure 2
Chest X-ray at the first hypotensive event. No specific findings were revealed at the event.
See this image and copyright information in PMC

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