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Hyperthyroidism and Thrombophilia in Cerebral Arterial and Venous Thrombosis: A Case Report and Critical Review

Liu, Jui-Chen MD; Huang, Hung Yu MD; Hsu, Yi-Ting MD

doi: 10.1097/NRL.0000000000000005
Case Report/Case Series

Introduction: People with hyperthyroidism, thrombophilia, or oral contraceptive (OC) use are reported to have a risk in developing arterial or venous thrombosis. There has been a rare case reporting concurrent arterial and venous thrombosis in such patients.

Case Report: We presented a 44-year-old woman with Grave disease and metabolic syndrome developing cerebral venous and arterial thrombosis and later deep vein thrombosis after OC use. At the acute stage, hyperthyroidism was associated with an increase in factor VIII and antithrombin III deficiency. At follow-up, antithrombin III level remained decreased. Her daughter with Hashimoto thyroiditis in a euthyroid state presenting with headache and OC use was also found to have antithrombin III deficiency.

Conclusions: Elevated factor VIII and antithrombin III deficiency were associated with a series of arterial and venous thrombotic events in this patient. Thyroid disease and OC use may have an impact on these coagulation parameters. We suggested that the exclusion of thrombophilia and of alterations of coagulative parameters should precede any decision of OC prescription in thyroid disease patient with a family history of venous thromboembolism.

Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan

The authors declare no conflict of interest.

Reprints: Yi-Ting Hsu, MD, Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, 2, Yuh-Der Road, 404 Taichung, Taiwan. E-mail:

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