Concurrent Arterial and Venous Thromboembolism While Receiving an Aromatase Inhibitor

A 49-year-old man presented with concurrent and widespread arterial and venous thromboembolism following a recent commencement of aromatase inhibitor therapy. Investigations revealed bilateral renal infarctions, complete occlusion of the superior mesenteric artery, and bilateral pulmonary emboli. He was noted to have heparin resistance when a heparin infusion was started. His treatment was transitioned to enoxaparin twice daily, resulting in a full resolution of symptoms.