Acne medication "caused young woman's death"

A young woman in Kalmar died from blood clots caused by a popular acne medication last week - just as Swedish researchers discovered that 86% of medical side effects are never reported to the proper authorities.

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The 20 year old's death has been linked to the combined acne and contraceptive medication 'Diane'. Four weeks after she started taking the Diane pill to treat her severe acne the 20 year old died of an acute pulmonary embolism. Lars Ahlgren, Consultant at Kalmar Hospital, said that a connection between the Diane pill and the young woman's death can't be ruled out.

"Just like other combination contraceptive pills this medication has known side effects," he said. "Since the woman was only 20 years old there is reason enough to assume there is a connection."

Aftonbladet reported that this particular combined oestrogen and progesterone pill may only be prescribed in Sweden to treat severe acne, whereas in other European countries it is also prescribed as a contraceptive. Although the young woman was prescribed the medication by her dermatologist, the Diane pill is readily available over the Internet, where it is advertised as "The contraceptive choice for clearer and more beautiful skin."

The website does not state specifically that use of the pill carries a four fold increase in the risk of thrombosis - the formation of a blood clot where there shouldn't be one - compared to women not using the pill.

Up to 2500 Swedish women are treated with Diane every year and Kerstin Jansson, a chemist at Läkemedelsverket, Sweden's medical products agency, said that there have been seven reports of blood clotting with the use of the pill in the last four years.

"Lung clots are the most common side effect that is reported, after weight gain, dizziness and depression," she said.

Manufacturer Schering doesn't deny the risks, but told Aftonbladet that they are no higher than with normal contraceptive pills.

"The prescribing doctor should always check for a history of thrombosis in the patient's family," commented Siv Eriksson, medical chef at Schering.
  
In another development this week, a study by Norrland's university hospital in Umeå claimed that Swedish doctors are seriously inefficient in reporting unexpected side-effects.

Tom Mjörndal, a consultant in clinical pharmacology at Umeå hospital, checked over 1349 cases, spread over five different hospitals in the northern province of Norrbotten. In all cases patients had suffered blood clots or other forms of irregular bleeding as a result of taking certain medication. In 107 cases it was safe to assume that there was a link with the medication, but only 15 cases were ever reported.

Tom Mjörndal suggested to Dagens Nyheter that simplifying reporting procedures might be the solution.

"This is very serious because it threatens patient safety and I don't really understand why doctors are so bad at reporting. It is better to report too much rather than too little because then we can warn patients and prescribing doctors in time."

DN wondered - optimistically - whether the situation in Norbotten might be exceptional, but according to Mjörndal, "northern Sweden is normally best in reporting side effects, so I hold out little hope that the situation in the rest of the country is any better".

As the late summer heat wave takes hold all across Sweden, the annual curse of the killer algae is spreading in the southern part of the Archipelago. Record high levels of phosphor in the Baltic Sea have seen the blue-green algae, a by-product of heavy industry, bloom as never before.

The stuff contains a liver toxin particularly dangerous to small children and has caused deaths in dogs and cattle. It is also blamed for skin and respiratory conditions, as well as depleting fish stocks. Central and southern parts of the waters between Sweden and the Baltic countries are the worst affected, especially around the islands of Gotland and Öland. When the algae are in their final phase of flowering they rise to the surface and are carried by wind and currents inland. If the water looks 'grubby' and discoloured, yellowy or blue green, it's a sign that the algae have landed.

And finally, sexually transmitted diseases are on the increase. The greatest concern is Chlamydia, up a rampant 69% in the first six months of the year compared to the same time period last year. Despite this prevalence, only 40% of people interviewed for a Gallup poll knew that Chlamydia can lead to infertility in men and women.

The problem is worst in Stockholm, according to Thursday's City. Some 16,000 people were infected with Chlamydia between January and July this year, an increase of 20%. Most of them are beween 15 and 25 years of age, clearly in the risk zone for future fertility problems.

Syphilis is also on the increase, with 20% more cases this year compared to the same time last year, and waiting times at STD clinics are now up to four weeks for a standard test.

There was some good news though. Gonorrhoea - which can lead to increased resistance to antibiotics - has dropped by 24% since last year.

Lysanne Sizoo

Lysanne Sizoo is a certified Counsellor, specialising in bereavement, fertility and cultural assimilation issues. She also runs a support and discussion group for English speaking women. You can contact her on sizoo@swipnet.se, or 08 717 3769. More information on www.sizoo.nu.