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A Case of Acute Cerebral Infarction and Thyroid Storm Associated with Moyamoya Disease
Int J Thyroidol 2017;10(1):56-60
Published online May 30, 2017;  https://doi.org/10.11106/ijt.2017.10.1.56
© 2017 Korean Thyroid Association.

Seol A Jang, Young Ha Baek, Tae Sun Park and Kyung Ae Lee

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
Correspondence to: Kyung Ae Lee, MD, PhD, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea
Tel: 82-63-250-2749, Fax: 82-63-254-1609, E-mail: kaleey@jbnu.ac.kr
Received February 20, 2017; Revised April 25, 2017; Accepted April 27, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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 thyrotoxicosisrelated 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.
Keywords : Moyamoya disease, Graves’ disease, Thyroid storm