Case Report: Hypothyroidism as a Possible Cause of an Acquired Reversible Hemolytic Anemia

Effect of Restoration of Euthyroidism on Peripheral Blood Cells and Erythropoietin in Women with Subclinical Hypothyroidism

“…Less frequent forms of anemia in hypothyroidism are hypochromic microcytic anemia associated with iron deficiency and, in patients with Hashimotos thyroiditis and autoimmune gastritis, macrocytic anemia induced by vitamin B12 3 or folic acid deficiency 1 . In contrast, hemolytic anemia is very rare in primary hypothyroidism 4 , though patients with beta thalassemia carry a high risk for development of hypothyroidism due to iron deposition in the thyroid gland 5 .…”

Hypothyroidism on Lipid Metabolism

“…In the red cell membrane, phosphatidylcholine and free cholesterol were increased, and the free cholesterol to phospholipid ratio was elevated. After levo-thyroxine therapy, the derangement of lipid levels was normalized with improvement of the hemolytic anemia (Nomura et al, 1991). In a hypothyroid patients group who were athyreotic as a consequence of ablation treatment for well-differentiated thyroid cancer, it was observed that the relative amounts of 18:2 omega 6 rose and those of 20:3 omega 6 fell, while the levels of all monounsaturated fatty acids increased in erythrocytes.…”

“…A case report of haemolytic anemia induced by hypothyroidism has been described in the literature (Nomura et al, 1991). An increased osmotic fragility is generally associated with haemolytic anemia (Schröter & Eber, 1989).…”