Unprovoked Isolated Pulmonary Embolism and Graves’ Disease in a Patient With Dyspnea: A Case Report

Abstract

Graves’ disease is a commonly diagnosed disease with a plethora of manifestations that can lead to its diagnosis. One of the rarer presentations of Graves’ disease is hypercoagulability with the development of spontaneous venous thrombosis. In patients presenting with unprovoked pulmonary embolism, we suggest evaluating the patient’s thyroid function tests as a potential underlying cause. To bring this issue to attention, we are presenting a rare case of isolated spontaneous pulmonary embolism development secondarily to underlying Graves’ disease.

Unusual chest pain and dyspnea

“…16 Screening for hyperthyroidism is often overlooked in patients with unprovoked pulmonary embolism. [17][18][19] One study demonstrated a 2.3-fold increase in the risk of pulmonary embolism in adults with hyperthyroidism during a 5-year follow-up of over 8000 patients. 20 Although hyperthyroidism is rare in children, and its symptoms are often subtle, the potential consequences should not be underestimated.…”

“…Hyperthyroidism is known to induce a hypercoagulable state due to elevated levels of serum fibrinogen, von Willebrand factor, and factor VIII, along with endothelial dysfunction and reduced fibrinolytic activity 16 . Screening for hyperthyroidism is often overlooked in patients with unprovoked pulmonary embolism 17–19 . One study demonstrated a 2.3‐fold increase in the risk of pulmonary embolism in adults with hyperthyroidism during a 5‐year follow‐up of over 8000 patients 20 …”