Pulmonary embolism as an initial finding of Graves’ disease
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thyroid diseases
Graves’ disease
embolism and thrombosis
pulmonary embolism

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Arenas, S., Amaya Veronesi, L., Nieto Zambrano, P. D. ., Mendieta Roa, D. E. ., Suárez Pinto, L. A., & Rojas, W. (2021). Pulmonary embolism as an initial finding of Graves’ disease. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 8(2). https://doi.org/10.53853/encr.8.2.712


Background: Graves' disease is known as one of the most common autoimmune thyroid diseases worldwide. This disease is particularly characterized by an increase in the production of thyroid hormones and coagulation factors, which causes a clinical syndrome with an autoimmune and metabolic component, typical of the physiological response to the stimulus of thyroxine. Constituting a risk factor for the presentation of thrombo embolic events.

The relationship that thyroid function has with the state of hemostasis at the body level has been described, and high concentrations of thyroid hormone have been associated with the risk of particularly venous thrombosis, finding alterations on the direct production of coagulation factors such as VIII , IX, and X, as in the plasminogen activator inhibitor gene (PAI-1) and Von Willebrand factor, which predispose to the presentation of thrombo-embolic events. There are also mechanical causes of vascular stasis in cases related to goiter, in addition to related cardiovascular complications such as atrial fibriation, which worse the prognosis of the patient.

Case presentation: We present the case of a woman with clinical and hospital admission diagnosis of a pulmonary consolidative process of infectious etiology, so it was decided to start empiric antibiotic therapy, however during hospital stay, the patient had a stationary clinical course, requiring increased supplemental oxygen. Persistent tachycardia and chest pain with pleuritic characteristics, for which reason an acute pulmonary embolism is exposed as a diagnostic possibility, performing angio / or autoimmune metabolic profile where a diagnosis of hyperthyroidism is made, for which they request a thyroid scintigraphy showing important uptake of X-rays. isotope being concordant with autoimmune etiology. The diagnosis of pulmonary embolism is documented and made as the initial finding of Graves' disease.

Discussion and conclusion: In this study a diagnosis of hyperthyroidism was made, so thyroid scintigraphy was requested, showing a significant uptake of radioisotope and being consistent with autoimmune etiology. A diagnosis of pulmonary embolism was documented and made as the initial finding of Graves' disease.

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