A Unique Case of Hypothyroidism Causing Pancytopenia With Literature Review

Abstract

Severe endocrinopathies can lead to pancytopenia. Hypothyroidism can affect any organ system including hematopoietic, resulting mainly in a normochromic normocytic anemia. Rarely, in severe hypothyroidism, all hematopoietic cell lines can be affected, resulting in pancytopenia. We, hereby, would like to discuss a case of hypothyroidism with worsening pancytopenia, which gradually improved after repletion with levothyroxine. Although pancytopenia is not a common feature of hypothyroidism, this case highlights the importance of hypothyroidism being considered as one of the differentials.

Anifrolumab for the treatment of refractory chilblain lupus erythematosus

“…Anifrolumab is Food and Drug Administration-approved for adult patients with moderate-to-severe SLE; however, emerging data suggest it may be a viable option for CLE as well. 2 In a randomized, double-blind, placebo-controlled study of 305 patients with moderate-to-severe SLE, the percentage of patients with a cutaneous lupus erythematosus disease area and severity index score of ≥10 who improved by ≥50% at week 52 was superior with both anifrolumab doses (300 mg: 63%; 1000 mg: 58%) as compared with placebo (31%). 2 Additionally, anifrolumab proved efficacious for patients with refractory CLE in multiple case reports 2 , 3 , 4 , 5 , 6 , 7 and in 2 small prospective studies, 8 , 9 one of which had a patient with CHLE.…”

“… 2 In a randomized, double-blind, placebo-controlled study of 305 patients with moderate-to-severe SLE, the percentage of patients with a cutaneous lupus erythematosus disease area and severity index score of ≥10 who improved by ≥50% at week 52 was superior with both anifrolumab doses (300 mg: 63%; 1000 mg: 58%) as compared with placebo (31%). 2 Additionally, anifrolumab proved efficacious for patients with refractory CLE in multiple case reports 2 , 3 , 4 , 5 , 6 , 7 and in 2 small prospective studies, 8 , 9 one of which had a patient with CHLE. This patient with CHLE showed a clinically meaningful improvement by 3 months, consistent with the patients in our case report.…”

Hypothyroidism Due to Seaweed Overconsumption

“…A case of severe hypothyroidism without autoantibodies in a patient who developed pancytopenia has been reported, indicating that hypothyroidism itself can cause pancytopenia regardless of the autoimmune process [9]. Recovery from pancytopenia varies according to reports, ranging from one week to two months with thyroid hormone supplementation [10].…”

Real‐life experience of anifrolumab for cutaneous lupus erythematous

“…3 Since then, real-world evidence further supports its efficacy in the literature. 1,2,[4][5][6][7][8][9][10][11][12] We present a challenging CHLE case that exhibited rapid response to anifrolumab, along with a literature review on its real-life effectiveness.A 19-year-old Caucasian female presented with a history of paediatric-onset SLE characterized by lymphopenia and positive antinuclear autoimmunity (ANA), antiribonucleoprotein (anti-RNP) and anticardiolipin antibodies. Cryoglobulins and TREX1 mutation tests were negative.…”

“…3 Since then, real-world evidence further supports its efficacy in the literature. 1,2,[4][5][6][7][8][9][10][11][12] We present a challenging CHLE case that exhibited rapid response to anifrolumab, along with a literature review on its real-life effectiveness.…”