Thyrotoxicosis Causing Arterial and Venous Thrombosis

Lodha, Ankur; Haran, Mehandi; Frankel, Robert; Shani, Jacob

doi:10.1097/maj.0b013e3181adb4c4

Cited by 11 publications

(7 citation statements)

References 5 publications

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“…21 Very recently, Lodha et al reported a case of thyrotoxicosis causing arterial (cerebral) and venous (pulmonary) thromboembolism in the same patient. 26 Hyperthyroidism increases the clearance rate of most of the coagulation factors. The turnover of factor (F) II, FVII, and FIX is increased, and the effect of oral anticoagulants is prolonged.…”

Section: Hypercoagulability In Hyperthyroidismmentioning

confidence: 99%

Thyroid Disorders and Hypercoagulability

Erem

2011

Semin Thromb Hemost

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Various abnormalities of coagulation and fibrinolysis, ranging from subclinical laboratory abnormalities to clinically significant disorders of hemostasis, but rarely major hemorrhage or thromboembolism, may occur in patients with thyroid diseases. This review discusses the relationships between thyroid dysfunction and the coagulation/fibrinolytic system. According to the recent literature, most of the coagulation/fibrinolytic abnormalities associated with thyroid dysfunction are the consequences of direct effects of thyroid hormones on the synthesis of various hemostatic parameters. Thyroid autoimmunity may also modify the processes of secondary hemostasis. Hyperthyroidism is generally associated with hypercoagulability and hypofibrinolysis, whereas the hemostatic profile in hypothyroidism depends on the severity of the disease. Both hypercoagulable and hypocoagulable states including increased fibrinolytic activity have been reported in hypothyroidism. Few data are available on hemostasis in subclinical thyroid diseases. In conclusion, adequate further prospective clinical studies of high quality including a larges series of patients are needed to explain the degree and type of coagulation/fibrinolytic abnormalities in patients with thyroid diseases.

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Section: Hypercoagulability In Hyperthyroidismmentioning

confidence: 99%

Thyroid Disorders and Hypercoagulability

Erem

2011

Semin Thromb Hemost

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“…[6][7][8][9][10] Although high concentrations of factor VIII and von Willebrand factor contribute to a hypercoagulable state in overt hyperthyroidism, lower von Willebrand factor concentrations found in overt hypothyroidism may, at least in part, protect against VT. 5,11 Regarding these alterations in coagulation factors, similar findings have been described for subclinical thyroid disease. 5 Subclinical thyroid disease has also been linked with arterial vascular disease, and there are good indications that variations in thyroid hormone levels within the physiologic range can modify the function of several organs.…”

Section: Introductionmentioning

confidence: 99%

Increasing levels of free thyroxine as a risk factor for a first venous thrombosis: a case-control study

Zaane

Squizzato

Huijgen

et al. 2010

Blood

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“…TBIIseronegative patients could be discovered only 5.4% cases in Graves' hyperthyroidism and it seemed to be less severe thyrotoxicosis and no Graves' orbitopathy. 4 However, after she was treated for thyrotoxicosis with methimazole for a month, a euthyroid state was achieved and the goiter was decreased to a normal size and this state has been maintained since then without any antithyroid drugs. We suggested she suffered transient thyrotoxicosis due to silent thyroiditis which is less common cause of thyrotoxicosis.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is very important to recognize it early and to initiate appropriate treatment [3]. The most common underlying cause of thyrotoxicosis is Graves' disease but transient thyrotoxicosis with a hypercoagulable state is very rare [4].…”

Section: Introductionmentioning

confidence: 99%

Massive pulmonary thromboembolism combined with transient thyrotoxicosis in an 18 year old girl

et al. 2020

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Background: Pulmonary thromboembolism (PTE) is thought to usually stem from deep vein thrombosis (DVT). However, evidence of DVT could not be found in many cases. Furthermore, transient thyrotoxicosis is a rare but potentially life-threatening emergency involving a systemic hypercoagulable state. We report on an 18 year-old-girl with transient thyrotoxicosis with massive PTE without DVT. Case presentation: An 18-year-old girl was admitted to the hospital with syncope. Patient had no history of trauma, any known underlying disease or oral contraceptives use. Chest computed tomography (CT) showed massive PTE in both central pulmonary arteries and diffuse goiter. However, a low extremity Doppler sonogram did not detect DVT. To manage the PTE, we administered low molecular weight heparin. On the other hands, thyroid function test indicated a state of thyrotoxicosis. In addition, patient had a partial protein S deficiency but no other immunologic abnormality. Therefore, the patient was diagnosed with massive PTE, thyrotoxicosis, and partial protein S deficiency. Patient was discharged with oral warfarin and methimazole. A follow-up echocardiogram obtained 3 months after anticoagulation therapy demonstrated normal dimensions and systolic function. After thyrotoxicosis was treated with methimazole for a month, a euthyroid state was achieved and the goiter decreased to a normal size. The methimazole was gradually tapered off and stopped at 4 months. At a 6-month follow up visit, PTE and pulmonary hypertension had disappeared but the patient still had a partial protein S deficiency. We decided to stop all medication with careful monitoring. During a 4year follow-up period after the episode, she was asymptomatic without any evidence of recurrent systemic thromboembolism or hyperthyroidism. Conclusions: Early recognition and appropriate treatment of PTE combined with transient thyrotoxicosis were vital to preventing other complications.

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Thyrotoxicosis Causing Arterial and Venous Thrombosis

Cited by 11 publications

References 5 publications

Thyroid Disorders and Hypercoagulability

Thyroid Disorders and Hypercoagulability

Increasing levels of free thyroxine as a risk factor for a first venous thrombosis: a case-control study

Massive pulmonary thromboembolism combined with transient thyrotoxicosis in an 18 year old girl

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