Endocrine Abstracts

Introduction: Venous thrombotic disease is a multicausal disease with many powerful risk factors (genetic, hormonal, environmental …). In recent years, several reports suggest possible relationships between hyperthyroidism and risk of venous thrombosis. We report the case of a patient with hyperthyroidism complicated by pulmonary embolism.

Case report: A 43-year-old female patient, who’s under treatment for a relapse of Grave’s disease, she was put on Dimazol 30 mg/day with poor adherence; the medication was discontinued 2 months ago. The patient was admitted for a proximal deep venous thrombosis in the left lower limb, complicated two days later by chest pain, dyspnea and hemoptysis. The diagnosis of pulmonary embolism was made, the patient still showed signs of hyperthyroidism: tachycardia with palpitation, weight loss, asthenia, diarrhea with tremor. The patient was hospitalized in cardiology intensive care unit. On examination the patient was: tachycardia at 138 bat/min, polypneic at 48c /min, BP: 14/08 with homogeneous flapping goiter and protruding eyes. Laboratory investigation reported: T4: 100 pmol/l, T3: 34pmol / l. The patient was put on Dimazol 80 mg/day, anticoagulant therapy and Beta blockers with good clinical and biological improvement.

Conclusion: Hyperthyroidism is a potentially serious disorder, but absolutely curable; it is widely associated with increased risk of prothrombotic and hypofibrinolytic states. This observation emphasizes the importance of determining the place of this disorder within the various known risk factors of the thrombotic disease, thus the need to put in place appropriate preventive measures, especially when the usually effective treatment of hyperthyroidism is in default.