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.

中文翻译：

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脑静脉血栓形成中的甲状腺功能障碍：一项回顾性队列研究

背景

脑静脉血栓形成（CVT）是一种具有多种相关疾病和危险因素的多因素疾病。甲状腺功能障碍——尤其是甲状腺功能亢进——与 CVT 相关，但这主要基于可追溯到 1913 年的病例报告，而缺乏解决该问题的系统调查。因此，我们在一个大型单中心 CVT 患者队列中调查了甲状腺功能障碍的频率和临床特征。

方法

我们回顾性地确定了 2006 年至 2020 年间在我们中心接受治疗的所有无菌 CVT 患者。临床信息是从我们的电子医疗文档系统中提取的。入院时常规测量促甲状腺激素 (TSH)，并在可用时分析游离甲状腺激素和甲状腺自身抗体。

结果

在 120 名影像学证实的 CVT 患者中，我们的主要分析包括 107 名可进行 TSH 测量的患者（平均年龄 42 ± 16 岁，74% 为女性）。19 名患者（17.8%，95% 置信区间 10-25%）患有甲状腺功能障碍。两人新诊断出由 Graves 病引起的甲状腺功能亢进（1.9%，95% 置信区间 0-4%），但这种情况没有典型症状。17 名患者（15.9%，95% 置信区间 9-23%）患有甲状腺功能减退症（12 名先前诊断为正在进行甲状腺激素替代治疗；5 名新诊断为亚临床甲状腺功能减退症）。与没有甲状腺功能障碍的患者相比，临床 CVT 特征相似。

结论

我们观察到 CVT 患者甲状腺功能障碍的患病率非常高。这一发现是否反映了因果关系值得进一步研究。尽管如此，这两种疾病的频繁共存仍支持对 CVT 患者进行 TSH 筛查。