Disorders of Granulopoiesis in Patients with Untreated Graves’ Disease

Ponassi, A; Morra, L; Colella, Giuseppe; Parodi, Gíovanní; Biassoni, P; Sacchetti, C

doi:10.1159/000206684

Cited by 13 publications

(20 citation statements)

References 6 publications

(9 reference statements)

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“…17,18 Another study proposed abnormal granulopoiesis and decreased marrow granulocyte reserve as the possible mechanisms for neutropenia. 19 Higher leucocyte numbers and neutrophil counts in smokers as compared to nonsmokers are well described. 8,9 Smokers also have higher haemoglobin concentrations because of relative hypoxia and higher carboxyhaemoglobin.…”

Section: Discussionmentioning

confidence: 97%

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Treatment of hyperthyroidism with antithyroid drugs corrects mild neutropenia in Graves' disease

Aggarwal

Tee

Saqib

et al. 2016

Clinical Endocrinology

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GD is associated with neutropenia in one in seven patients at diagnosis, especially in non-Caucasians and those with higher serum thyroid hormone levels. Neutrophil counts increase with treatment with ATD and are related to reduction in thyroid hormone concentrations. It is therefore important to check neutrophil levels in newly diagnosed patients with GD prior to commencing ATD therapy as otherwise low levels may incorrectly be attributed to ATD therapy.

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Section: Discussionmentioning

confidence: 97%

“…Some studies have shown an association of neutropenia with the presence of antineutrophil antibodies . Another study proposed abnormal granulopoiesis and decreased marrow granulocyte reserve as the possible mechanisms for neutropenia …”

Section: Discussionmentioning

confidence: 99%

Treatment of hyperthyroidism with antithyroid drugs corrects mild neutropenia in Graves' disease

Aggarwal

Tee

Saqib

et al. 2016

Clinical Endocrinology

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“…Bei bis zu 31% der Patienten mit Morbus Basedow und assoziierter Beteiligung der äußeren Augenmuskulatur (MorbusBasedow-assoziierte Ophthalmopathie, BAO) sind antinukleäre Antikörper nachweisbar.Bei einem Morbus Basedow ohne Augenmuskelbeteiligung fehlt gewöhn-lich der ANA-Nachweis [14]. Eine Zuordnung zu einem bestimmten Zielantigen innerhalb der antinukleären AK gelingtwie in unserem Fall -jedoch meist nicht.…”

Section: Diskussionunclassified

“…Hämatologische Veränderungen wie Anämie (34%), Leukozytopenie (5,8-20%),und Thrombozytopenie (3,3%) werden beschrieben [3,7,14]. Für die hä-matologischen Veränderungen werden sowohl immunologische als auch metabolische (erhöhte "turn-over"-Rate bei hyperthyreoter Stoffwechsellage) Mechanismen diskutiert [3,7,14].…”

Section: Diskussionunclassified

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Morbus Basedow

et al. 2004

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Graves disease is a frequent cause (30-40%) of hyperthyroidism. In addition to the classic clinical triad (goiter, exophthalmos and tachycardia), symptoms relating to other organ systems may be found at presentation. Cutaneous manifestations play an important role and may initially be the only clue to the endocrine disorder. A 40-year-old woman with Graves disease presented with features of systemic lupus erythematosus. She had a malar rash, as well as marked hematological changes (thrombocytopenia and leukocytopenia) and antinuclear antibodies (1:640). She also had hyperthyroidism and Graves disease-specific thyroid autoantibodies (TSIg). Her symptoms improved after initiation of antithyroid therapy. Because of overlapping clinical and laboratory criteria, Graves disease can mimic systemic lupus erythematosus. The differentiation requires careful laboratory evaluation. Moreover, both autoimmune diseases may occur in the same patient.

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Causes of incidental neutropenia in adulthood

et al. 2006

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The incidental discovery of neutropenia during routine blood counting represents a common problem for clinicians. However, there are no reported data of systematic evaluations of adults with incidental neutropenia. As such, this was the aim of the present study. Ninety-seven adults with incidental neutropenia were submitted to a clinical and laboratory approach including medical evaluation, complete blood count (CBC), serial CBC, direct and indirect antiglobulin test, bone marrow smear and biopsy, assessment of folate, vitamin B12 and iron status, serum liver enzymes, serum proteins, serological exams for hepatitis B and C virus, cytomegalovirus, mononucleosis, human immunodeficiency virus and toxoplasmosis, detection of lupus erythematosus cells, antinuclear and anti-DNA antibodies and rheumatoid factor, dosage of free thyroxin and thyrotropin, chest roentgenogram and abdominal echography. Chronic idiopathic neutropenia of adults was identified in 34.0% of the individuals, neutropenia due to exposure to chemical agents was seen in 16.5%, infectious diseases in 9.3%, autoimmune diseases in 9.3%, haematological diseases in 9.3%, thyroid disorders in 8.2%, ethnic neutropenia in 7.2%, drug-related neutropenia in 2.1%, cyclic neutropenia in 2.1% and iron deficiency in 2.1%. Recovery or improvement of the neutrophil count was seen upon treatment or recuperation from infectious, autoimmune, haematological and thyroid diseases and iron supplementation. We conclude that the evaluation of individuals with incidental neutropenia using a structured approach may make the identification of clinically silent diseases possible, and provide an opportunity for early treatment, avoiding complications of the diseases and consequences of neutropenia.

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Disorders of Granulopoiesis in Patients with Untreated Graves’ Disease

Cited by 13 publications

References 6 publications

Treatment of hyperthyroidism with antithyroid drugs corrects mild neutropenia in Graves' disease

Treatment of hyperthyroidism with antithyroid drugs corrects mild neutropenia in Graves' disease

Morbus Basedow

Causes of incidental neutropenia in adulthood

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