[Serious jaundice and thyrotoxic myocardiopathy with atrial thrombus].

نویسندگان

  • Marcus V Leitão de Souza
  • Fernanda Satake Novaes
چکیده

Jaundice related to thyrotoxicosis and not as an effect of antithyroid drugs is a rare complication that usually occurs in the presence of heart failure (HF) or hepatitis. We report a case of a 54-year-old white woman with hyperthyroidism caused by Graves's disease and jaundice despite methimazole suspension. Bilirubin fluctuated at high values, between 30.0 and 52.3 mg/dL, transaminases were slightly increased, on admission ALT = 46 U/L and AST = 87 U/L; coagulation indices and serum proteins were on the lower limit of the normal range with PT 68% and albumin = 2.5 g/dL. Serology for hepatitis was negative. After the first radioiodine therapy (RT), bilirubin reached its maximum, which coincided with the worst period of HF exacerbation. Bilirubin normalized 4 weeks after the second RT, with the stabilization of HF and normalization of thyroid hormones. We discuss the possible etiologies of severe jaundice in hyperthyroid patients, as well as the difficult anticoagulant therapy with warfarin.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Intracardiac Thrombosis in Sickle Cell Disease

In patients with sickle cell disease, thrombotic microangiopathy is a rare complication. Also in sickle cell disease, intracardiac thrombus formation without structural heart diseases or atrial arrhythmias is a rare phenomenon. We herein describe a 22-year-old woman, who was a known case of sickle cell-βthalassemia, had a history of recent missed abortion, and was admitted with a vaso-occlusive...

متن کامل

Jaundice Heralding the Onset of Thyrotoxic Crisis.

Thyrotoxic crisis is a life threatening medical condition that requires urgent diagnosis and treatment. Because of the wide variety of presenting symptoms, its diagnosis can be difficult in some cases and a high index of suspicion is required for diagnosis. We present a case of 53 year old patient who presented with fever, jaundice and passage of loose stools. Upon investigations other etiologi...

متن کامل

Syncope Due to a Free-floating Left Atrial Thrombus

A 74-year-old woman with nonvalvular chronic atrial fibrillation was admitted for pre-syncope. She fainted and developed acute arterial occlusion after one month of admission. Echocardiogram showed a 2.6×2.8-cm free-floating ball thrombus in the left atrium (LA) that had not been documented at the initial admission. Its left lateral decubitus position caused left ventricular (LV) inflow obstruc...

متن کامل

بررسی عوامل موثر بر لخته داخل دهلیز چپ در بیمارانی که تحت عمل جراحی دریچه میترال قرار گرفته اند

Background and Aim: Rheumatic heart disease (RHD) is a serious health problem in developing countries. Mitral stenosis is one of the most prevalent forms of RHD and one of the causes of systemic thromboembolism in Iran. The present study was conducted to evaluate the relationship between left atrial clot and mitral valve disease. Materials and Methods: This case-control study was done on all p...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Arquivos brasileiros de endocrinologia e metabologia

دوره 56 7  شماره 

صفحات  -

تاریخ انتشار 2012