Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Autoimmune polyglandular syndrome type 3 diagnosed with cerebral venous sinus thrombosis:a case report

Daichi Terunuma, M.D.1), Shuhei Egashira, M.D.1), Ryousuke Doijiri, M.D.1), Naoto Kimura, M.D., Ph.D.2), Yo Hashimoto, M.D.3) and Takahiko Kikuchi, M.D., Ph.D.1)

1) Department of Neurology, Iwate Prefectural Central Hospital
2) Department of Neurosurgery, Iwate Prefectural Central Hospital
3) Department of Diabetes and Endocrinology, Iwate Prefectural Central Hospital

A 67-year-old woman with a history of diabetes mellitus was admitted to our hospital with convulsions due to bilateral frontal subcortical hemorrhages. MR venography showed a defect in the superior sagittal sinus, and thrombi were demonstrated in the same lesion with head MRI three-dimensional turbo spin echo T1-weighted imaging. She was diagnosed with cerebral venous sinus thrombosis. As precipitating factors, we found high levels of free T3 and T4, low levels of thyroid stimulating hormone, anti-thyroid stimulating hormone receptor antibody, and anti-glutamic acid decarboxylase antibody with her. We diagnosed her with autoimmune polyglandular syndrome type 3 with Graves' disease and slowly progressive type 1 diabetes mellitus. Since she also had nonvalvular atrial fibrillation, she was treated with apixaban subsequently to intravenous unfractionated heparin in the acute phase, resulting in partial regression of the thrombi. Autoimmune polyglandular syndrome should be considered when multiple endocrine disorders are identified as precipitating factors for cerebral venous sinus thrombosis.
Full Text of this Article in Japanese PDF (2268K)

(CLINICA NEUROL, 63: 298|304, 2023)
key words: cerebral venous sinus thrombosis, Graves' disease, type 1 diabetes mellitus, autoimmune polyglandular syndrome, head MRI three-dimensional turbo spin echo with variable flip angle

(Received: 20-Dec-22)