Madroñero-Vuelta A B, Sanahuja-Montesinos J, Bergua-Llop M, Araguás-Arasanz C
Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Lleida, Spain.
Rev Neurol. 2004;39(6):533-5.
Recently, thyrotoxicosis has been described as a risk factor for cerebral venous thrombosis (CVT) in some reported cases. We present a case of CVT associated to a subacute De Quervain's thyroiditis in a young female who was an heterozygous carrier for the G20210A mutation of the prothrombin gene.
A 42-year-old female with irrelevant past medical history developed a thrombosis of the superior sagital and right transverse sinus in the initial phase of a subacute thyroiditis. Diagnosis was made by thyroid radioactive iodine uptake, and cerebral computerized tomography scan, magnetic resonance imaging, and magnetic resonance angiography. Treatment with aspirin and corticosteroids was started until thyroid function was normalized. When CVT diagnosis was made, the patient was treated with anticoagulation. Two months later, magnetic resonance imaging showed resolution of the CVT. The patient was diagnosed as an heterozygous carrier for the G20210A mutation of the prothrombin gene by genetic studies.
Subacute thyroiditis might act as a risk factor for CVT, increasing the thrombotic risk in the presence of other acquired or hereditary prothrombotic factors, such as the G20210A mutation of the prothrombin gene in our patient.
最近,在一些报道的病例中,甲状腺毒症被描述为脑静脉血栓形成(CVT)的一个危险因素。我们报告一例年轻女性亚急性亚急性德奎尔万甲状腺炎伴发CVT的病例,该女性是凝血酶原基因G20210A突变的杂合子携带者。
一名既往病史无特殊的42岁女性在亚急性甲状腺炎初期发生上矢状窦和右侧横窦血栓形成。通过甲状腺放射性碘摄取、脑部计算机断层扫描、磁共振成像和磁共振血管造影进行诊断。开始使用阿司匹林和皮质类固醇治疗,直至甲状腺功能恢复正常。确诊CVT后,对患者进行抗凝治疗。两个月后,磁共振成像显示CVT消失。通过基因研究,患者被诊断为凝血酶原基因G20210A突变的杂合子携带者。
亚急性甲状腺炎可能是CVT的一个危险因素,在存在其他获得性或遗传性血栓形成前因素(如我们患者中的凝血酶原基因G20210A突变)时增加血栓形成风险。