Our findings suggest that fibrocytes may participate in the pathogenesis of TAO because they express relevant autoantigens such as IGF-I receptor and functional TSHR and differentially accumulate in orbital tissue in TAO.

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SUMMARY Background Graves’ disease (GD) is associated with hyperthyroidism. Thyrotoxicosis adversely affects multiple organ systems including hematopoiesis. Anemia occurring specifically in GD has not been systematically studied previously. Objective To define the prevalence and characteristics of the anemia associated with GD. Design Eighty Seven newly diagnosed patients with GD were recruited. Hematologic indices, thyroid function and inflammatory parameters were examined at presentation and following successful treatment. Setting Tertiary care academic referral center. Results Thirty three percent of subjects presented with anemia. The prevalence of anemia not attributable to other causes (GD anemia) was 22%. GD anemia affected 41.6% (10/24) of men compared to 17.5% of women (11/63). Mean EPO levels (15.5 ± 5.3 mIU/ml) were within normal reference limits but significantly higher (P=0.004) than those of the non-anemic controls. Hgb correlated inversely with EPO (P=0.05) and CRP (P=0.04) levels, a relationship that persisted after multivariate adjustment for TT3 or TT4. With antithyroid therapy for 16 ± 6.3 weeks, Hgb levels normalized in 8/9 subjects with GD anemia (10.7 ± 0.8 g/dl to 13.5 ± 1.3 g/dl, P=0.0001). After correction of Hgb, mean MCV and TIBC were significantly increased and median ferritin and mean Epo were significantly decreased. Conclusions GD anemia is common, resembles the anemia of chronic disease and is associated with markers of inflammation. It corrects promptly with the return to the euthyroid state following treatment.