A Case of Graves' Disease with Pancytopenia

Shin, Jong Ho; Kim, Hyun Jin; Kim, Si Bum; Kim, Dong Pil; Ko, Bong Suk; Kim, Jimyung; Gong, Soo Jung; Lee, Jung Ae

doi:10.3803/jkes.2009.24.4.272

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…9 It is suggested that a cross antigenicity between human TSH receptors and polynuclear neutrophils, a decreased circulating time of granulocytes, and a reduced marrow granulocyte reserve are the causes of neutropenia in thyrotoxicosis. 7,10 In this case, lymphocyte values were not compatible with Kocher's blood picture. And excessively corrected leukopenia was caused by short-term use of steroids in the early.…”

Section: Discussionmentioning

confidence: 64%

A Case of Pancytopenia with Hyperthyroidism

Kim

Yoon

Park

et al. 2013

Yeungnam Univ J Med

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There has been an increase in the number of reports of atypical manifestations of Graves' disease (GD), such as jaundice, anemia, thrombocytopenia and leukopenia. Pancytopenia also rarely occurs in GD. In this paper, a case of pancytopenia with GD that was successfully treated with an anti-thyroid drug is reported. In this case, a 69-year-old woman showed pancytopenia with a normal peripheral blood smear, bone marrow aspiration smear and bone marrow biopsy. Her thyroid function test and thyroid scintigraphy confirmed her hyperthyroid status. Her laboratory abnormality and clinical condition improved after she was treated with an anti-thyroid drug. This is a rare case of pancytopenia associated with GD.

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Section: Discussionmentioning

confidence: 64%

A Case of Pancytopenia with Hyperthyroidism

Kim

Yoon

Park

et al. 2013

Yeungnam Univ J Med

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“…Some autoimmune processes are also suspected of gradually affecting the bone marrow stem cells due to excess hormone secretion [ 9 , 10 ]. According to the literature, 22% of Graves’ disease patients have anemia [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Non-myeloproliferative Pancytopenia: A Rare Presentation of Thyrotoxicosis

Rahmathullah¹,

Umakanth²,

Singhapathirane³

2023

Cureus

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Thyrotoxicosis-induced pancytopenia is a rare manifestation. The practical challenge is to differentiate thyrotoxicosis-induced pancytopenia from the side effects of anti-thyroid treatment following the commencement of treatment. Although some of the possible underlying pathogeneses have been reported, the complete mechanisms remain unclear concerning pancytopenia in uncontrolled thyrotoxicosis. Thyrotoxicosis-induced pancytopenia is completely reversible with the administration of anti-thyroid drugs at an appropriate time and regular follow-up to prevent further recurrence.

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“…[28] It has been suggested that a cross antigenicity between TSH receptors and polynuclear neutrophils, a decreased circulating time of granulocytes and reduced marrow granulocyte reserve are the causes of neutropenia in thyrotoxicosis. [29,30] However, these still remain controversial .When slight leucopenia, neutropenia and thrombocytopenia are common manifestations of Graves disease even in untreated cases and believed to be an autoimmune process, use of anti-thyroid medications mainly Thiamazole could cause serious life-threatening agranulocytosis. This critical condition however occurs only in 1% of patients within the 1st few weeks or months of the treatment.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmopathy and other influential factors for liver abnormalities in patients with Graves’ disease

Pudasaini

Yang

Ma³

2020

Preprint

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Background - Abnormal liver function tests (LFTs) is a common phenomenon in patients having Grave’s disease that tends to affect the treatment choice. Only few data on factors and biochemical indexes that contributes to such abnormalities in Graves patients are documented till date. Objective - The objective of this study was to explain the potent factors including ophthalmopathy for hepatic dysfunction evoked by Grave's disease alone. Method - A cohort of 263 patients who were newly diagnosed and untreated for Grave’s disease were studied. Clinical characteristics and all the biochemical values were collected and further analysis was done. These patients were further divided into two groups: group A with abnormal LFTs and group B with normal LFTs. Data were analyzed by using tests like the independent samples t- tests, chi-square tests and logistic regression tests. Result - Among them, 175(66.53%) were found to have at least one LFT abnormality. The frequencies of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (γ-GGT), total bilirubin (TBIL) and direct bilirubin (DBIL) were 54.9% (96/175), 29.7% (52/175), 29.7% (52/175), 38.3% (67/175), 33.1% (58/175) and 34.3% (60/175) respectively of which ALT was the commonest abnormality In the univariate analysis, group A patients had higher FT3 and FT4 than group B while group B had higher white blood cells (WBC) count mainly granulocyte % and ophthalmopathy than group A. Results of multivariate logistic regression identified FT3 and ophthalmopathy as independent factors predicting abnormal LFTs [odds ratio (OR) = 1.062, 95% confidence interval (CI) = 1.028–1.096 and OR = 0.355, 95% CI = 0.195–0.647 respectively] . Conclusion - While FT3 value > 5.70 pmol/L showed consistent association with liver function abnormality in patients with Graves, in contrast, ophthalmopathy showed inverse association with liver function abnormalities.

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A Case of Graves' Disease with Pancytopenia

Cited by 4 publications

References 13 publications

A Case of Pancytopenia with Hyperthyroidism

A Case of Pancytopenia with Hyperthyroidism

Non-myeloproliferative Pancytopenia: A Rare Presentation of Thyrotoxicosis

Ophthalmopathy and other influential factors for liver abnormalities in patients with Graves’ disease

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