Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu City, Chiba, Japan.
Department of Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu City, Chiba, Japan.
Am J Case Rep. 2021 Apr 5;22:e929565. doi: 10.12659/AJCR.929565.
BACKGROUND Non-malignant and non-cirrhotic portal and mesenteric vein thrombosis is rare. It has been reported that the hyperthyroid state is associated with increased risks of venous thrombosis due to increases in levels of various coagulation and anti-fibrinolytic factors. Particularly, changes in levels of these factors are also reported in cases of portal and mesenteric vein thrombosis. Although hyperthyroidism is not known as a risk factor for portal and mesenteric vein thrombosis, it might be an underlying pathogenesis of hyperthyroidism-associated portal and mesenteric vein thrombosis. CASE REPORT A 59-year-old Japanese man with a history of Grave's disease presented with acute portal and mesenteric vein thrombosis and hyperthyroidism. Anticoagulation therapy was initiated and the dose of antithyroid drug was increased. He underwent various tests to identify causes of portal and mesenteric vein thrombosis. However, all test results were within normal range except for hyperthyroidism. Therefore, we discontinued anticoagulation therapy after normalization of thyroid hormone status. After 3 years, he experienced recurrence of portal vein thrombosis concomitant with hyperthyroidism. CONCLUSIONS Hyperthyroidism might be associated with portal vein thrombosis. Thyroid function tests should be performed in cases of portal and mesenteric vein thrombosis in the absence of other risk factors.
非恶性和非肝硬化性门静脉和肠系膜静脉血栓形成较为罕见。已有研究报道称，由于各种凝血和抗纤维蛋白溶解因子水平的升高，甲状腺功能亢进状态与静脉血栓形成的风险增加有关。特别是，门静脉和肠系膜静脉血栓形成病例中也报道了这些因子水平的变化。尽管甲状腺功能亢进症不被认为是门静脉和肠系膜静脉血栓形成的危险因素，但它可能是甲状腺功能亢进症相关门静脉和肠系膜静脉血栓形成的潜在发病机制。
一名 59 岁日本男性，患有格雷夫斯病病史，出现急性门静脉和肠系膜静脉血栓形成和甲状腺功能亢进症。启动了抗凝治疗，并增加了抗甲状腺药物的剂量。他进行了各种检查以确定门静脉和肠系膜静脉血栓形成的原因。然而，除了甲状腺功能亢进症外，所有检查结果均在正常范围内。因此，在甲状腺激素状态正常化后，我们停止了抗凝治疗。3 年后，他在甲状腺功能亢进症的同时出现门静脉再发血栓形成。
甲状腺功能亢进症可能与门静脉血栓形成有关。在无其他危险因素的情况下，应在出现门静脉和肠系膜静脉血栓形成时进行甲状腺功能检查。
