[Cerebral venous thrombosis associated to subacute De Quervain's thyroiditis in a carrier for the G20210A mutation of the prothrombin gene]. / Trombosis venosa cerebral asociada a tiroiditis subaguda de De Quervain en una paciente con la mutación G20210A del gen de la protrombina.

INTRODUCTION: 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. CASE REPORT: 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. CONCLUSIONS: 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.

Trombosis venosa cerebral asociada a tiroiditis subaguda de De Quervain en una paciente con la mutación G20210A del gen de la protrombina / Cerebral venous thrombosis associated to subacute De Quervain's thyroiditis in a carrier for the g20210a mutation of the prothrombin gene

Introducción. Recientemente se ha descrito la tirotoxicosis como factor desencadenante de trombosis venosa cerebral (TVC) en diversos casos aislados. Se describe un caso de TVC asociada a tiroiditis subaguda de De Quervain en una mujer heterocigota para la mutación G20210A del gen de la protrombina. Caso clínico. Mujer de 42 años, sin antecedentes personales de interés, que durante la fase inicial de una tiroiditis subaguda desarrolló una trombosis del seno longitudinal superior y el seno transverso derecho. El diagnóstico por imagen se hizo mediante gammagrafía tiroidea, así como tomografía axial computarizada, resonancia magnética y angiorresonancia cerebral. Se inició el tratamiento con ácido acetilsalicílico y posteriormente esteroides orales, hasta normalizarse la función tiroidea. Una vez diagnosticada la TVC se instauró un tratamiento anticoagulante, con resolución de la TVC por resonancia magnética a los dos meses. El estudio genético demostró que era heterocigota para la mutación G20210A del gen de la protrombina. Conclusiones. La tiroiditis subaguda podría actuar como factor desencadenante de TVC, y aumentar el riesgo de TVC cuando se asocia a otros factores protrombóticos adquiridos o hereditarios, como, en nuestro caso, la mutación G20210A del gen de la protrombina (AU)

Introduction. 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. Case report. 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. Conclusions. 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 (AU)

[Cold thyroid nodules: study of 163 cases (author's transl)]. / Nódulos fríos tiroideos: a propósito de 163 casos.

A group of 163 patients with cold thyroid nodules was studied. Of these, 131 underwent surgery with thyroid neoplasms being found in 33 cases (22.13%). No statistically significant differences were seen in frequency of neoplastic cold thyroid nodules between males and females; in time of evolution between neoplastic and non-neoplastic cold thyroid nodules; or in mean age of the groups with neoplastic and non-neoplastic cold nodules. On the other hand, there were significant differences between the mean age of patients with different types of thyroid neoplasms. In conclusion, as at present no diagnostic technique allowing a clear differentiation between neoplastic and non-neoplastic cold thyroid nodules is available for preoperative use, surgical intervention is desirable in cases of this type.