A Case of Thyrotoxicosis with Pancytopenia.

Abstract

Abstract.We report a 49-year-old man with primary hyperthyroidism who presented with pancytopenia.

Treatment of hyperthyroidism with antithyroid drugs corrects mild neutropenia in Graves' disease

“…Previous studies have reported the prevalence of neutropenia in hyperthyroidism to be between 15% and 30% . In addition, small studies and a few case reports have also shown normalization of neutrophil counts with normalization of thyroid function . These reports were based on small numbers of patients and did not assess other factors associated with neutrophil counts in hyperthyroidism.…”

“…13,14 In addition, small studies and a few case reports have also shown normalization of neutrophil counts with normalization of thyroid function. 7,[13][14][15][16] These reports were based on small numbers of patients and did not assess other factors associated with neutrophil counts in hyperthyroidism. Our study of neutrophil counts has collected data in a prospective and systematic manner in patients at baseline, prior to ATD therapy, and after achieving euthyroidism.…”

Thyroid storm complicated by bicytopenia and disseminated intravascular coagulation

“…First, the patient had bicytopenia, manifested as leukopenia and thrombocytopenia. Thyroid hormones facilitate the production of blood cells by stimulating hematopoietic stem cells [4]. However, they also reduce the life-span of blood components by a β-adrenergic mechanism [12] or by stimulation of the reticulo-endothelial system.…”

“…However, they also reduce the life-span of blood components by a β-adrenergic mechanism [12] or by stimulation of the reticulo-endothelial system. Although this suggests that pancytopenia is likely to be a complication of thyrotoxicosis, cases of isolated anemia or thrombocytopenia are more frequently reported [4,5]. Autoimmune mechanisms may also play a role, suggested by the potential complication of idiopathic thrombocytopenic purpura (ITP) and pernicious anemia [4,5], and there have been reports that thyrotoxicosis might directly suppress hematopoiesis in the bone marrow [12].…”

“…Graves’ disease is an autoimmune disorder characterized by hyperthyroidism, ophthalmopathy, and dermopathy, which can be complicated by various autoimmune blood disorders, including hemolytic anemia [4], idiopathic thrombocytopenic purpura [5], and iron deficiency anemia [6]. …”