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Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study

BACKGROUND: Cerebral venous thrombosis (CVT) is a multifactorial disease with a variety of related conditions and risk factors. Thyroid dysfunction—especially hyperthyroidism—has been linked to CVT, but this is mainly based on case reports ranging back to 1913, while systematic investigations addres...

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Autores principales: Fandler-Höfler, Simon, Pilz, Stefan, Ertler, Marion, Haidegger, Melanie, Kneihsl, Markus, Wünsch, Gerit, Gary, Thomas, Enzinger, Christian, Gattringer, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940832/
https://www.ncbi.nlm.nih.gov/pubmed/34468799
http://dx.doi.org/10.1007/s00415-021-10776-3
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author Fandler-Höfler, Simon
Pilz, Stefan
Ertler, Marion
Haidegger, Melanie
Kneihsl, Markus
Wünsch, Gerit
Gary, Thomas
Enzinger, Christian
Gattringer, Thomas
author_facet Fandler-Höfler, Simon
Pilz, Stefan
Ertler, Marion
Haidegger, Melanie
Kneihsl, Markus
Wünsch, Gerit
Gary, Thomas
Enzinger, Christian
Gattringer, Thomas
author_sort Fandler-Höfler, Simon
collection PubMed
description BACKGROUND: Cerebral venous thrombosis (CVT) is a multifactorial disease with a variety of related conditions and risk factors. Thyroid dysfunction—especially hyperthyroidism—has been linked to CVT, but this is mainly based on case reports ranging back to 1913, while systematic investigations addressing this issue are lacking. Therefore, we investigated the frequency and clinical characteristics of thyroid dysfunction in a large single-center cohort of CVT patients. METHODS: We retrospectively identified all consecutive patients with aseptic CVT treated at our center between 2006 and 2020. Clinical information was extracted from our electronic medical documentation system. Thyroid-stimulating hormone (TSH) had been routinely measured at admission, free thyroid hormones and thyroid autoantibodies were analyzed whenever available. RESULTS: Of 120 patients with imaging-confirmed CVT, our main analysis included 107 patients (mean age 42 ± 16 years, 74% female) in whom TSH measurements were available. Nineteen patients (17.8%, 95% confidence interval 10–25%) had thyroid dysfunction. Two had newly diagnosed hyperthyroidism (1.9%, 95% confidence interval 0–4%) caused by Graves’ disease, but without typical symptoms for this condition. Seventeen patients (15.9%, 95% confidence interval 9–23%) had hypothyroidism (12 previously diagnosed with ongoing thyroid hormone replacement therapy; 5 with newly diagnosed subclinical hypothyroidism). Clinical CVT characteristics were similar comparing patients with versus without thyroid dysfunction. CONCLUSION: We observed a remarkably high prevalence of thyroid dysfunction in CVT patients. Whether this finding reflects a causal relationship warrants further studies. Despite that, the frequent coexistence of both diseases argues for TSH screening in CVT patients.
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spelling pubmed-89408322022-04-07 Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study Fandler-Höfler, Simon Pilz, Stefan Ertler, Marion Haidegger, Melanie Kneihsl, Markus Wünsch, Gerit Gary, Thomas Enzinger, Christian Gattringer, Thomas J Neurol Original Communication BACKGROUND: Cerebral venous thrombosis (CVT) is a multifactorial disease with a variety of related conditions and risk factors. Thyroid dysfunction—especially hyperthyroidism—has been linked to CVT, but this is mainly based on case reports ranging back to 1913, while systematic investigations addressing this issue are lacking. Therefore, we investigated the frequency and clinical characteristics of thyroid dysfunction in a large single-center cohort of CVT patients. METHODS: We retrospectively identified all consecutive patients with aseptic CVT treated at our center between 2006 and 2020. Clinical information was extracted from our electronic medical documentation system. Thyroid-stimulating hormone (TSH) had been routinely measured at admission, free thyroid hormones and thyroid autoantibodies were analyzed whenever available. RESULTS: Of 120 patients with imaging-confirmed CVT, our main analysis included 107 patients (mean age 42 ± 16 years, 74% female) in whom TSH measurements were available. Nineteen patients (17.8%, 95% confidence interval 10–25%) had thyroid dysfunction. Two had newly diagnosed hyperthyroidism (1.9%, 95% confidence interval 0–4%) caused by Graves’ disease, but without typical symptoms for this condition. Seventeen patients (15.9%, 95% confidence interval 9–23%) had hypothyroidism (12 previously diagnosed with ongoing thyroid hormone replacement therapy; 5 with newly diagnosed subclinical hypothyroidism). Clinical CVT characteristics were similar comparing patients with versus without thyroid dysfunction. CONCLUSION: We observed a remarkably high prevalence of thyroid dysfunction in CVT patients. Whether this finding reflects a causal relationship warrants further studies. Despite that, the frequent coexistence of both diseases argues for TSH screening in CVT patients. Springer Berlin Heidelberg 2021-09-01 2022 /pmc/articles/PMC8940832/ /pubmed/34468799 http://dx.doi.org/10.1007/s00415-021-10776-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Communication
Fandler-Höfler, Simon
Pilz, Stefan
Ertler, Marion
Haidegger, Melanie
Kneihsl, Markus
Wünsch, Gerit
Gary, Thomas
Enzinger, Christian
Gattringer, Thomas
Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
title Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
title_full Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
title_fullStr Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
title_full_unstemmed Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
title_short Thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
title_sort thyroid dysfunction in cerebral venous thrombosis: a retrospective cohort study
topic Original Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940832/
https://www.ncbi.nlm.nih.gov/pubmed/34468799
http://dx.doi.org/10.1007/s00415-021-10776-3
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