Lee, Kuang-YenKuang-YenLeeCheng, Chieh-LungChieh-LungChengYING-CHENG CHIANG2025-09-152025-09-152025-09https://scholars.lib.ntu.edu.tw/handle/123456789/732028Objective: We presented a rare case of aortic mural thrombosis with bilateral renal infarction in a woman taking dienogest for adenomyosis. The objective is to highlight the possible risk of thrombosis in woman with antiphospholipid syndrome taking progestin-only contraceptives for endometriosis. Case report: We presented a 48-year-old woman who has adenomyosis for years. After using dienogest for 1 month, she experienced severe abdominal pain and was diagnosed to have dienogest-induced aortic mural thrombosis and bilateral renal infarction. Successful treatment was achieved with the use of heparin followed by edoxaban. Intriguingly, the patient was diagnosed to have antiphospholipid syndrome 4 months later. The patient remained under regular follow-up for two years, during which no further thrombotic episodes were noted. Conclusion: Progestin-only contraceptives may be an acceptable choice for patients with adenomyosis and antiphospholipid syndrome, the risk of thrombosis should still be kept in mind.enAdenomyosisAntiphospholipid syndromeAortic mural thrombosisDienogest[SDGs]SDG3journal article10.1016/j.tjog.2024.08.01540935463