Antithyroid drug-induced pancytopenia followed by acute lymphoblastic leukemia: A rare case

Nehara, Hardeva Ram; Gupta, Bal Kishan; Parmar, Sahil; Kumar, Vipin; Sihag, Dharmveer; Beniwal, Surender

doi:10.4103/trp.trp_45_20

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…In vitro, it has been shown that the lymphocytes of agranulocytic patients have the risk of transformation to blast cells if exposed to ATD [14]. Nehara HR et al have lately reported a young adult male with GD and pancytopenia who developed ALL four months after re-exposure to carbimazole [13]. That is in contrast to our patient who withdrew the carbimazole eight months before developing the ALL.…”

Section: Discussioncontrasting

confidence: 72%

“…The exact underlying mechanism of GD related BMI is still not well recognized. The cytotoxic effect of the ATDs or the autoimmune reaction on the bone marrow antecedents are postulated to be possible pathogenic factors [13]. The later hypothesis might be emphasized by the detection of anti-granulocyte antibodies in some of those who received ATD [8].…”

Section: Discussionmentioning

confidence: 99%

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Acute Lymphoblastic Leukemia Complicating Graves’ Disease in a Sudanese Adolescent Girl: A Case Report and Exploration of the Underlying Mechanism Possibilities

Fadlalbari¹,

Hassan²,

Abdallah

et al. 2021

Preprint

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Background: Graves’ Disease (GD) related bone marrow injury presents usually as agranulocytosis or less commonly as pancytopenia. However, acute lymphoblastic leukemia (ALL) has been reported recently in an adult patient with GD. The underlying pathogenesis is not fully understood. Nevertheless, the harmful effect of anti-thyroid drugs or autoimmune reaction to bone marrow cells is anticipated to be the causative factors. Case report: A 16.5-year-old Sudanese girl with GD was on carbimazole for the first fourteen months of her illness, with irregular follow up, then it was withdrawn because she developed hypothyroidism for which she was put on thyroxine. Meanwhile, she developed severe anemia without fever which necessitated blood transfusion. Eight months later, she presented with thyrotoxicosis relapse, febrile illness and pancytopenia which was proved to be ALL on bone marrow examination. Conclusion: ALL must be considered when encountering a GD patient with pancytopenia.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia Complicating Graves’ Disease in a Sudanese Adolescent Girl: A Case Report and Exploration of the Underlying Mechanism Possibilities

Fadlalbari¹,

Hassan²,

Abdallah

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In vitro, it has been shown that the lymphocytes of agranulocytic patients have the risk of transformation to blast cells if exposed to ATD [10]. Nehara et al [9] have lately reported a young adult male with GD and pancytopenia who developed ALL 4 months after re-exposure to carbimazole. This is in contrast to our patient who withdrew the carbimazole 8 months before developing ALL.…”

Section: Discussionmentioning

confidence: 99%

“…The exact underlying mechanism of GD-related BMI is still not well recognized. The cytotoxic effect of the ATDs or the autoimmune reaction on the bone marrow antecedents is postulated to be possible pathogenic factor [9]. The latter hypothesis might be emphasized by the detection of anti-granulocyte antibodies in some of those who received ATD [7].…”

Section: Discussionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia in an Adolescent Girl with Graves’ Disease: A Coincidence or Consequence

Fadlalbari¹,

Hassan²,

Abdalla

et al. 2022

Dubai Diabetes Endocrinol J

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Background: Graves’ disease (GD)-related bone marrow injury presents usually as agranulocytosis or less commonly as pancytopenia. However, acute lymphoblastic leukemia (ALL) has been reported recently in an adult patient with GD. The underlying pathogenesis is not fully understood. Nevertheless, the harmful effects of anti-thyroid drugs or autoimmune reaction to bone marrow cells are anticipated to be the causative factors. Case Presentation: We report a 16.5-year-old girl with GD who was on carbimazole for the first 14 months of her illness, with irregular follow-up; then it was withdrawn because she developed hypothyroidism. Meanwhile, she developed severe anemia without fever which necessitated blood transfusion. Eight months later, she presented with thyrotoxicosis relapse, febrile illness, bone pain, and pancytopenia which was proved to be ALL on bone marrow examination. Conclusion: The presence of ALL in a young GD patient is an unprecedented event. Although it is difficult to demonstrate the causality between them, need for further studies cannot be denied.

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Zoledronic acid–induced severe lymphopenia

Karpuz

2023

Osteoporos Int

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Antithyroid drug-induced pancytopenia followed by acute lymphoblastic leukemia: A rare case

Cited by 3 publications

References 6 publications

Acute Lymphoblastic Leukemia Complicating Graves’ Disease in a Sudanese Adolescent Girl: A Case Report and Exploration of the Underlying Mechanism Possibilities

Acute Lymphoblastic Leukemia Complicating Graves’ Disease in a Sudanese Adolescent Girl: A Case Report and Exploration of the Underlying Mechanism Possibilities

Acute Lymphoblastic Leukemia in an Adolescent Girl with Graves’ Disease: A Coincidence or Consequence

Zoledronic acid–induced severe lymphopenia

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