Spontaneous Thyroid Hemorrhage on Chronic Anticoagulation Therapy

Gunasekaran, Kulothungan; Rudd, Kelly; Murthi, Swetha; Kaatz, Scott; Lone, Nazir A.

doi:10.4081/cp.2017.932

Cited by 11 publications

(10 citation statements)

References 19 publications

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Section: Discussionmentioning

confidence: 99%

“…The risk of bleeding is increased due to immature angiogenesis, arteriovenous shunt, increased vascular flow, and thyroid gland fragility. Anticoagulants can also increase the severity of spontaneous bleeding (54). Elbers et al (55) indicated that low thyroid hormone concentrations could shift the hemostatic system towards hypocoagulability and a hyperfibrinolytic state, which may increase the bleeding risk.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review

et al. 2021

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PurposeLangerhans cell histiocytosis (LCH) is a rare clonal disorder of Langerhans antigen-presenting cells. However, thyroid LCH involvement is relatively rare. We present the first case of spontaneous thyroid hemorrhage due to LCH progression and discuss the clinical features, diagnosis, and treatments of thyroid LCH in a literature review.MethodsClinical data were collected. Previously published articles on thyroid LCH involvement were reviewed to assess the clinical features, diagnosis, and treatments for thyroid LCH.ResultsA 54-year-old female presented with a multi-system LCH, affecting the uterus, liver, pituitary gland, and thyroid gland. Clinical stability was achieved after systemic chemotherapy. After 7 years of regular follow up, the patient complained of a sudden painful neck swelling and progressive dyspnea. Computed Tomography revealed bilateral goiter with hematoma, and the patient was diagnosed with spontaneous thyroid bleeding based on her clinical symptoms and radiological findings. The patient was incubated to relieve airway compromise and partial thyroidectomy was performed for definitive treatment. Pathological evaluation further confirmed the diagnosis of thyroid LCH. The patient recovered well after surgery.ConclusionSpontaneous thyroid bleeding due to thyroid LCH progression is extremely rare. Treatments for LCH vary depending on the severity of the disease. We suggest that, for patients with multi-system LCH with thyroid lesion, long-term active surveillance of thyroid hormone concentrations, and thyroid gland volume is required. Physicians should be alert of the potentially life-threatening spontaneous thyroid hemorrhage when aggravated diffuse goiter and hypothyroidism appear. Further investigation is required to establish the guidelines for thyroid LCH treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review

et al. 2021

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“…Risk factors for intraparenchymal bleeding include the use of anticoagulants [5,6], fibrinolytic therapy [7,8], trauma [9][10][11], and invasive diagnostic procedures such as thyroid needle biopsy [12][13][14], although rare cases of spontaneous bleeding have been described [15].…”

Section: Discussionmentioning

confidence: 99%

Death due to external compression of the trachea in a patient with multinodular hemorrhagic goiter

dell’Aquila

Matteis

Bolino

et al. 2019

Forensic Sci Med Pathol

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In this paper we describe the case of an 81-year-old Caucasian female (142 cm tall, weighing 45 kg) who suffered from a multinodular goiter for approximately 40 years. Following the onset of a clinical condition characterized by acute respiratory failure, she was transported to the emergency room by ambulance, where she died within a few hours after admission. A recent cardiac examination showed the absence of risk factors for cardiovascular disease, sinus tachycardia with a heart rate of 131 bpm, negative objectivity for signs of cardiocirculatory failure, a blood pressure of 120/80 mmHg and modest exertional dyspnea. A recent hemochemical laboratory analysis showed a TSH value of 0.01microUI/mL, FT3 value of 4.76 pg/mL and FT4 value of 2.33 ng/mL, pointing to a pattern of hyperthyroidism, attributable to Basedow's goiter. Autopsy showed some peculiarities, and we came across two extremely rare findings; the thyroid gland had reached a very large size in relation to the patient's body mass (1510 g, in a patient of 142 cm and 45 kg), and the death of the patient was due to the development of a massive intra-thyroid hemorrhage that had caused acute external compression of the trachea. To the best of our knowledge this very rare event has not previously been reported in the international scientific literature.

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“…Thyroid gland hemorrhage is a life-threatening situation if not managed promptly and correctly. Spontaneous intrathyroidal hemorrhage (ITH) causing airway obstruction is relatively rare and different causes are reported in the literature ( 1 , 2 , 3 , 4 ). Spontaneous hemorrhage of the thyroid gland usually occurs in cases with thyroid nodules and cysts; however, the reason for rupture is still not clear ( 2 , 4 , 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Management of a Spontaneous Thyroid Nodule Hemorrhage Causing Acute Airway Obstruction

Başak¹,

Yücel²,

Hasanova³

et al. 2021

TAO

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Spontaneous intrathyroidal hemorrhage (ITH) causing airway obstruction is relatively rare. We report a case with no known history of a thyroid disease that presented with an ITH causing severe airway obstruction as a life-threatening situation. A 57-year-old female patient presented to the emergency department with sudden onset of swelling of the anterior neck, severe dyspnea, and unconsciousness. Computerized tomography scan after intubation revealed a 6.2x5.3 cm mass originating from the right thyroid lobe and compressing the airway. Drainage of hematoma with right lobectomy was done. When the patient was extubated one day after the surgery the vocal cords were found to be mobile. She was discharged after two days and there was no need for further intervention during the one-month follow-up. Spontaneous life-threatening ITHs are rare entities. Immediate assessment of airway obstruction and achieving a secure airway are crucial. Besides drainage of hematoma, thyroidectomy may also be necessary.

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Spontaneous Thyroid Hemorrhage on Chronic Anticoagulation Therapy

Cited by 11 publications

References 19 publications

Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review

Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review

Death due to external compression of the trachea in a patient with multinodular hemorrhagic goiter

Management of a Spontaneous Thyroid Nodule Hemorrhage Causing Acute Airway Obstruction

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