Rayan MN, Jones TS, Ruiz de Villa A, Calestino M, Bazikian Y. Venous Thromboembolism and Thymic Hyperplasia in the Setting of Silent Graves' Disease.
Cureus 2022;
14:e23935. [PMID:
35547433 PMCID:
PMC9085705 DOI:
10.7759/cureus.23935]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/26/2022] Open
Abstract
Venous thromboembolism is a common, yet serious life-threatening condition that has many well-recognized associations which include but are not limited to pregnancy, polycythemia, trauma, immobility, and malignancy. The pathophysiology behind the pro-coagulant effects of hyperthyroidism has been well established; however, there are no current guidelines regarding deep venous thrombosis (DVT) surveillance in patients with hyperthyroidism. In this report, we discuss the case of a 36-year-old female with no significant past medical history (PMH) with the exception of a 15 pack-year smoking history, who presented to us with an extensive, rapidly-progressing lower extremity DVT. Despite aggressive treatment measures, she developed a pulmonary embolus in the hospital. During her stay, she was diagnosed with Graves’ disease by hormone profile and thyroid-stimulating hormone receptor (TSH-R) antibody positivity. Additionally, an incidental thymic mass, likely thymic hyperplasia, was found on imaging and presumed to be associated with Graves’ disease. This case study reports a difficult-to-treat venous thromboembolism in the setting of Graves’ disease along with a review of current literature and pathophysiology on the subject.
Collapse