I read with concern the article by Gill et al,1 published in the July 22, 2002, issue of the ARCHIVES, which describes an episode of massive bleeding in a woman whose regular medications included pentosan polysulfate sodium (Elmiron; Alza Pharmaceuticals, Mountain View, Calif). This report is seriously misleading and raises an unnecessary and probably groundless alarm concerning pentosan polysulfate.
Most troubling is the authors' omission of critical clinical information from the abstract of the article. The abstract does not mention the laceration of the carotid artery, the patient's chronic malnourished disease state, or the unknown status of her clotting factors before surgery. In fact, after reading the abstract, one is left with the very misleading impression that the patient simply walked in off the street with a spontaneous and massive hemorrhage, which was definitely not the case. Unfortunately, the abstract of this article will enjoy far wider readership than the full text; therefore, an incomplete and extremely misleading subset of the clinical data will be propagated.