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      Cerebral venous thrombosis associated with thyrotoxicosis, the use of desmopressin and elevated factor VIII/von Willebrand factor

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          Abstract

          Cerebral venous thrombosis (CVT) is an uncommon disorder associated with diverse processes. We report a patient who, while receiving desmopressin and contraceptive pills (OCP), developed straight sinus thrombosis. Clinical assessment and laboratory investigations revealed untreated hyperthyroidism and a hypercoagulable state, characterised by high levels of von Willebrand factor, factor VIII coagulant activity and IgM cardiolipin antibody. The clinical picture improved with anticoagulation, treatment of hyperthyroidism and discontinuation of OCP and desmopressin. To the best of our knowledge, the association between the use of oral desmopressin and CVT has not been described. The multiple risk factors present in our case were probably additive in increasing the risk of CVT. Although this case represents a rare occurrence, practitioners should be alerted to the possible associations of desmopressin, oral contraceptives and Graves' disease with venous thrombosis.

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          Author and article information

          Journal
          BMJ Case Rep
          BMJ Case Rep
          casereports
          bmjcasereports
          BMJ Case Reports
          BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
          1757-790X
          2016
          8 August 2016
          : 2016
          Affiliations
          [1 ] Department of Neurological Sciences, University of Vermont , Burlington, Vermont, USA
          [2 ] Department of Medicine, University of Vermont , Burlington, Vermont, USA
          Author notes
          [Correspondence to ] Dr Waqar Waheed, waqar.waheed@ 123456uvmhealth.org
          Article
          PMC4986025 PMC4986025 4986025 bcr-2016-216584
          10.1136/bcr-2016-216584
          4986025
          27503942
          2016 BMJ Publishing Group Ltd
          Categories
          Article
          Findings That Shed New Light on the Possible Pathogenesis of a Disease or an Adverse Effect
          1517
          Female
          31-50 years
          White
          USA/Canada
          Case Report

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