ECEESPE2025 ePoster Presentations Multisystem Endocrine Disorders (51 abstracts)
Hyperthyroidism and thrombosis of a varicocele: an unexpected linka case report
Abdejlil Barhoumi 1 , Sana Abid 1 , Ines Bayar 1 , Kamar Ezzamene Mahmoud 1 , Bilel Ben Amor 1 , Ekram Hajji 1 , Hela Marmouch 1 , Hanene Sayadi 1 & Inès Khochteli 1
1Fattouma Bourguiba University Hospital, Department of Internal Medicine and Endocrinology, Monastir, Tunisia
JOINT2303
Introduction: Venous thromboembolic disease (VTE) is a multifactorial condition primarily associated with hypercoagulable states. Hyperthyroidism is one such condition, promoting a procoagulant state. We report a case of varicocele thrombosis associated with hyperthyroidism, with no other identified risk factors.
Case Report: A 48-year-old man with no significant medical history was followed in the endocrinology department for hyperthyroidism due to a Grave disease with multinodular goiter. Clinically, he presented with thyrotoxicosis syndrome without an obvious goiter or exophthalmos. Laboratory tests revealed a TSH level of 0.01 mIU/land FT4 at 29.5 pmol/l, with positive TSH receptor antibodies. He was started on antithyroid therapy, followed by definitive treatment with radioactive iodine. Inflammatory markers and hemostasis tests were within normal ranges. Additionally, the patient experienced testicular pain with a sensation of heaviness. A scrotal ultrasound revealed left varicocele thrombosis. He was treated with analgesics and oral anticoagulants, leading to a favorable clinical and biological outcome.
Discussion: Hyperthyroidism induces a hypercoagulable state, promoting a prothrombotic condition and increasing the risk of VTE disease. Varicocele thrombosis is a rare cause of testicular pain. Other reported etiologies include trauma, obstruction of venous drainage by malignant tumors, genital and/or inguinal infections, and coagulation disorders.
Conclusion: Hyperthyroidism can be considered a risk factor for thrombosis, implying that it should be discussed as a probable etiology, especially in the presence of other clinical elements.
References: 1. Adjadohoun S, Kiki S, Akanni D, et al. Thrombose spontanée d’une varicocèle droite à propos d’un cas. 2020;12:170-173. 2. Kleinclauss F, Della Negra E, Martin M, Bernardini S, Bittard H. [Spontaneous thrombosis of left varicocele]. Prog Urol. 2001;11(1):95-96.
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