P200 – 2741: Autoimmune thyroiditis presenting as a cerebral vein thrombosis in a child: A case report

Abstract

Objective Cerebral vein thrombosis (CVT) is a multifactorial condition that many systemic ilnesses constitute the risk factors. Mostly, hyperthyroidism has been associated with CVT in case reports, and increased levels of factor VIII and von Willebrand factor have been proposed as the possible link in this association. On the other hand, only a few study showing the relation of autoimmune thyroiditis and CVT in adults but there is no study or reports regarding the children. To our knowledge, this is the first case report of autoimmoune thyroiditis presenting as CVT in a child. Methods The patient was 11 years old girl, presenting with headache and right hemiplegia. CVT was diagnosed with MRI and MR venography. Subclinic hypothyroidism was diagnosed in the acute phase of CVT. She had an autoimmune thyroiditis but no diffuse goiter. No other risk factors for CVT was detected. She was treated with anticoagulation and thyroid replacement therapy with excellent clinical outcome. Results The relation between autoimmune thyroiditis and CVT in this patient should emphasize importance of hypothroidism in pediatric population as causing cerebrovascular pathology. Several hemostatic and fibrinolytic parameters have been demonstrated to be impaired in hypothyroidism suggesting a possible role of this disease in CVT pathogenesis. Beside, indirect evidence also supports possible endothelial dysfunction and venous stasis in hypothyroidism, further emphasizing the physiopathological relation between the two conditions. More research is needed to establish a possible causal role of hypothyroidism on CVT. Conclusion We strongly suggest that thyroid function should be screened in pediatric patients presenting with CVT even if there is no clinical symptoms of hypothyroidism.