P03.16 Idiosyncratic Reaction to Mirena IUS A Cause for Early Re...

P03.16 Idiosyncratic Reaction to Mirena IUS A Cause for Early Removal - Case Report Sivarajan, S; Aung, SN; Haloob, R Basildon University Hospital, UK Background: The discontinuation rate for mirena IUS was around 40%. The common causes for premature removal were excessive bleeding, spotting, infection and pain. We all are aware of less systemic effects compared to other progestational agents, We would like to highlight the importance of exaggerated minerolocorticoid activity in the form of increased fluid retention and electrolyte changes with spontaneous changes in weight and generalized edema following mirena IUS which result in early removal. In our two cases, we highlight the exacerbation of well documented side effects of progesterone which leads to premature removal of MIRENA IUS. In my first case,Twenty four hours after insertion of mirena IUS she noticed ankle swelling, 48 hours later swelling involved the whole lower limb and worse over the following few days.In addition to heavy vaginal bleeding.At the end of the first week, she put on weight three quarters of a stone (10.5 lb).Mirena was removed at surgery after 8 days of insertion and she developed continuous diuresis and profuse sweating within 24hrs of removal her weight went down by 7lbs. In the second case ,following mirena IUS insertion Three months later her periods improved a lot , but she suffered considerable weight gain(7lb) and mood swings. So she decided to have her mirena removed and opted for Novasure ablation. Conclusion: Although abdominal pain,peripheral oedema,nervousness are well documented side effects of Mirena,we couldn’t find in literature of fulminant oedema and water retention after 24 hours of Mirena insertion. This profound acute side effects might be due to acute idiosyncratic immune reaction of to progesterone (extracted from: ****** ) Thank you, Mo, for finding this info on the net! Claudia