Spontaneous thyroid hemorrhage on chronic anticoagulation therapy

  • Kulothungan Gunasekaran | stankuloth@gmail.com Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY; Division of Hospital Medicine, Henry Ford Hospital, Detroit, MI, United States.
  • Kelly M. Rudd Department of Pharmaceutical Care Services, Section of Clinical Pharmacy, Bassett Medical Center, Cooperstown, NY, United States.
  • Swetha Murthi Department of Internal Medicine, Sinai Grace Hospital, Detroit, MI, United States.
  • Scott Kaatz Division of Hospital Medicine, Henry Ford Hospital, Detroit, MI, United States.
  • Nazir Lone Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, United States.

Abstract

Even though highly vascularized, the thyroid gland rarely has spontaneous bleeding. Bleeding into the thyroid gland can result in potentially lethal acute airway compromise. This case report describes an elderly patient on warfarin for atrial fibrillation, who presented with swelling on the right side of her neck causing acute airway obstruction. An urgent computed tomography of the neck showed an enlarging hemorrhage into the right lobe of the thyroid gland. She was initially intubated for airway protection and her anticoagulation was reversed to stop the bleeding. She was closely monitored in the intensive care unit. After an uncomplicated tracheal extubation and recovery, she was discharged and scheduled for an elective total thyroidectomy. We desire that physicians be aware of this rare, potentially lethal bleeding complication.

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Published
2017-02-06
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Section
Case Reports
Keywords:
Thyroid gland, hemorrhage, anticoagulation.
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How to Cite
Gunasekaran, K., Rudd, K. M., Murthi, S., Kaatz, S., & Lone, N. (2017). Spontaneous thyroid hemorrhage on chronic anticoagulation therapy. Clinics and Practice, 7(1). https://doi.org/10.4081/cp.2017.932

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