Venous Thromboembolism and Thymic Hyperplasia in the Setting of Silent Graves' Disease


North Florida


North Florida Regional Medical Center

Document Type

Case Report

Publication Date



deep venous thrombosis, thymic hyperplasia, thymic lymphoid hyperplasia, incidental thymic mass, clotting in thyroid disorders, dvt, venous thromboembolism, hypercoagulability in graves' disease


Cardiovascular Diseases | Endocrinology, Diabetes, and Metabolism | Internal Medicine


Venous thromboembolism is a common, yet serious life-threatening condition that has many well-recognized associations which include but are not limited to pregnancy, polycythemia, trauma, immobility, and malignancy. The pathophysiology behind the pro-coagulant effects of hyperthyroidism has been well established; however, there are no current guidelines regarding deep venous thrombosis (DVT) surveillance in patients with hyperthyroidism. In this report, we discuss the case of a 36-year-old female with no significant past medical history (PMH) with the exception of a 15 pack-year smoking history, who presented to us with an extensive, rapidly-progressing lower extremity DVT. Despite aggressive treatment measures, she developed a pulmonary embolus in the hospital. During her stay, she was diagnosed with Graves’ disease by hormone profile and thyroid-stimulating hormone receptor (TSH-R) antibody positivity. Additionally, an incidental thymic mass, likely thymic hyperplasia, was found on imaging and presumed to be associated with Graves’ disease. This case study reports a difficult-to-treat venous thromboembolism in the setting of Graves’ disease along with a review of current literature and pathophysiology on the subject.

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