A Case of Acute Cerebral Infarction and Thyroid Storm Associated with Moyamoya Disease
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Coexistence of moyamoya disease and Graves’ disease is rare. A 41-year-old woman presented with symptoms of left-sided hemiparesis and dysarthria. Magnetic resonance imaging and angiography revealed acute infarction of the right thalamus and occipital lobe with complete obstruction of the distal internal carotid arteries and obstruction of the right P2. Free thyroxine, thyroid-stimulating hormone (TSH), and TSH receptor antibody levels were 79.33 pmol/L, 0.007 uIU/mL, and 151.5 u/L, respectively. She received antiplatelet therapy and standard antithyroid drug dose. After admission, seizure and unexplained fever occurred. The thyroid storm score (Burch and Wartofsky scale) was 90 points. After intensive treatment, mental status and thyrotoxicosis- related symptoms ameliorated and vital signs stabilized. We describe a case of thyroid storm following cerebrovascular ischemic events in a Korean woman with moyamoya disease and Graves’ disease. Thyroid storm combined with cerebrovascular events can lead to severe morbidity and mortality. Prompt recognition and strict management are crucial.
Abstract
Coexistence of moyamoya disease and Graves’ disease is rare. A 41-year-old woman presented with symptoms of left-sided hemiparesis and dysarthria. Magnetic resonance imaging and angiography revealed acute infarction of the right thalamus and occipital lobe with complete obstruction of the distal internal carotid arteries and obstruction of the right P2. Free thyroxine, thyroid-stimulating hormone (TSH), and TSH receptor antibody levels were 79.33 pmol/L, 0.007 uIU/mL, and 151.5 u/L, respectively. She received antiplatelet therapy and standard antithyroid drug dose. After admission, seizure and unexplained fever occurred. The thyroid storm score (Burch and Wartofsky scale) was 90 points. After intensive treatment, mental status and thyrotoxicosis- related symptoms ameliorated and vital signs stabilized. We describe a case of thyroid storm following cerebrovascular ischemic events in a Korean woman with moyamoya disease and Graves’ disease. Thyroid storm combined with cerebrovascular events can lead to severe morbidity and mortality. Prompt recognition and strict management are crucial.
참고문헌 (17)
- Im SH, "Moyamoya disease associated with Graves disease: special considerations regarding clinical significance and management", J Neurosurg, 102(6), pp.1013~1017 (2005)
- Burch HB, "Life-threatening thyrotoxicosis", Thyroid storm. Endocrinol Metab Clin North Am, 22(2), pp.263~277 (1993)
- Ren SC, "Von Willebrand factor and coagulation factor VIII in Moyamoya disease associated with Graves' disease: a case report", Exp Ther Med, 12(5), pp.3195~3200 (2016)
- 백지훈, "병발된 그레이브스병과 중증근무력증 환자에서 진단된 모야모야병 1예", 대한내과학회지, 79(2), pp.195~200 (2010), 대한내과학회
- 신동원, "갑상선독성발작과 연관된 모야모야병의 급성뇌경색", 대한신경과학회지, 32(2), pp.95~97 (2014), 대한신경과학회
- 전종근, "Two adolescent patients with coexistent Graves' disease and Moyamoya disease in Korea", Korean Journal of Pediatrics, 57(6), pp.287~291 (2014), 대한소아과학회
- Shen AL, "Concurrent moyamoya disease and Graves' thyrotoxicosis: case report and literature review", Acta Neurol Taiwan, 15(2), pp.114~119 (2006)
- Sasaki T, "Co-morbidity of moyamoya disease with Graves' disease. report of three cases and a review of the literature", Intern Med, 45(9), pp.649~653 (2006)
- Siegert CE, "Superior sagittal sinus thrombosis and thyrotoxicosis. Possible association in two cases", Stroke, 26(3), pp.496~497 (1995)
- Ni J, "Moyamoya syndrome associated with Graves' disease: a case series study", Ann Transl Med, 2(8), pp.77~ (2014)
- Lei C, "Association of moyamoya disease with thyroid autoantibodies and thyroid function: a case-control study and meta-analysis", Eur J Neurol, 21(7), pp.996~1001 (2014)
- Kim SJ, "Association of thyroid autoantibodies with moyamoya-type cerebrovascular disease: a prospective study", Stroke, 41(1), pp.173~176 (2010)
- Colleran KM, "Potential association of thyrotoxicosis with vitamin B and folate deficiencies, resulting in risk for hyperhomocysteinemia and subsequent thromboembolic events", Endocr Pract, 9(4), pp.290~295 (2003)
- Iso H, "Serum total homocysteine concentrations and risk of stroke and its subtypes in Japanese", Circulation, 109(22), pp.2766~2772 (2004)
- van Diemen-Steenvoorde R, "Quasi-moyamoya disease and heterozygosity for homocystinuria in a five-year-old girl", Neuropediatrics, 21(2), pp.110~112 (1990)
- 이란, "A Case of Moyamoya Disease in a Girl with Thyrotoxicosis", Yonsei Medical Journal, 50(4), pp.594~598 (2009), 연세대학교의과대학
- Hsu SW, "Rapidly progressive fatal bihemispheric infarction secondary to Moyamoya syndrome in association with Graves thyrotoxicosis", AJNR Am J Neuroradiol, 27(3), pp.643~647 (2006)