title: Hyperthyroidism and thrombophilia in cerebral arterial and venous thrombosis: a case report and critical review.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
authors.affiliation: Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Jui-Chen
authors.initials: JC
authors.lastname: Liu
authors.forename: Hung Yu
authors.initials: HY
authors.lastname: Huang
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Hsu
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D002536:Cerebral Arteries / Q000503:physiopathology; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications*; D008279:Magnetic Resonance Imaging; D019851:Thrombophilia / Q000150:complications*; D020246:Venous Thrombosis / Q000150:complications*