Hyperthyroidism associated with autoimmune hemolytic anemia and periodic paralysis. A report of a case in which antihyperthroid therapy alone was effective against hemolysis.

Ogihara, Tohru; Katoh, Hiroshi; Yoshitake, Hiroko; Iyori, Shigeru; Saito, Ikuo

doi:10.2169/internalmedicine1962.26.401

Cited by 15 publications

(13 citation statements)

References 2 publications

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“…Furthermore, increased blood flow, due to hyperthyroidism, increases phagocytosis in the reticuloendothelial system (21). In the present case, the platelet count temporarily increased after PTU therapy and this normalized thyroid function.…”

Section: Discussionsupporting

confidence: 53%

Successful Remission of Evans Syndrome Associated with Graves' Disease by Using Propylthiouracil Monotherapy

et al. 2011

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A 46-year-old woman with Graves' disease was admitted for anemia and thrombocytopenia. She had previously been treated with methimazole but she self-discontinued the treatment 6 months prior to admission. She was diagnosed with Evans syndrome associated with Graves' disease and treated with propylthiouracil without corticosteroids, which normalized her thyroglobulin level. Surprisingly, while Evans syndrome is characterized by frequent relapses, this patient has been in remission of Evans syndrome for approximately 4 years. The remission of Evans syndrome associated with Graves' disease in the absence of immunosuppressive therapy suggests that these 2 diseases have a common pathogenetic mechanism.

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Section: Discussionsupporting

confidence: 53%

Successful Remission of Evans Syndrome Associated with Graves' Disease by Using Propylthiouracil Monotherapy

et al. 2011

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“…It has previously been reported that serum EPOlevels are increased in hyperthyroid patients, and that T4 and T3 stimulate EPO synthesis (1 1). Induction of anemia in non-hemodialysis patients due to a hyperthyroid state has been reported, although rarely, but in those cases, it was caused by hemolytic anemia and aplastic anemia (5,12,13). As far as we know, there have been no reports of primary hyperthyroidisminduced hemolytic anemia or aplastic anemia in hemodialysis patients.…”

Section: Case Reportmentioning

confidence: 99%

Primary Hyperthyroidism Induced Erythropoietin-resistant Anemia?

et al. 1997

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We describe a 26-year-old male hemodialysis patient with erythropoietin (EPO) resistant anemia associated with primary hyperthyroidism. Use of the anti-hyperthyroid drug, methimazole, led to improvement of his hyperthyroidism and anemia. Before the anti-hyperthyroid therapy, he had received transfusions to maintain an adequate hematocrit during recombinant human EPOtherapy. After the therapy, his hyperthyroidism improved and his hematocrit gradually increased without any transfusion. These findings suggest that the patient's EPO resistant anemia was the result of primary hyperthyroidism, and that this complication is reversible if accurate treatment is given. (Internal Medicine 36: 903-905, 1997)

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“…The association of GD with autoimmune haemolytic anemia has been described in single case reports in the English and non-English literatures [20–23]. It appears that autoimmune haemolytic anemia is much less commonly found in association with GD when compared with immune thrombocytopenia and pernicious anemia [24].…”

Section: Anemiamentioning

confidence: 99%

“…Ikeda et al reported a case of Evans' syndrome in a patient with GD that was not hyperthyroid after treatment with radioiodine, and suggested that an underlying immunological mechanism could be responsible for the association [25]. In this regard it was very interesting to get an effective control of hemolysis with the use of an antithyroid drug alone (namely, propylthiouracil) that was observed in a case of autoimmune haemolytic anemia [20], and in another one with Evan's syndrome [26]. This finding might be related to the earlier observation that microsomal antibodies and TSH receptor antibodies decreased in parallel, while patients with GD were taking carbimazole, whereas no significant changes were observed during treatment with placebo or propranolol [27].…”

Section: Anemiamentioning

confidence: 99%

Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth

Hegazi

Ahmed

2012

Journal of Thyroid Research

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Over the past few decades, there has been an increase in the number of reports about newly recognized (atypical or unusual) manifestations of Graves' disease (GD), that are related to various body systems. One of these manifestations is sometimes the main presenting feature of GD. Some of the atypical manifestations are specifically related to GD, while others are also similarly seen in patients with other forms of hyperthyroidism. Lack of knowledge of the association between these findings and GD may lead to delay in diagnosis, misdiagnosis, or unnecessary investigations. The atypical clinical presentations of GD include anemia, vomiting, jaundice, and right heart failure. There is one type of anemia that is not explained by any of the known etiological factors and responds well to hyperthyroidism treatment. This type of anemia resembles anemia of chronic disease and may be termed GD anemia. Other forms of anemia that are associated with GD include pernicious anemia, iron deficiency anemia of celiac disease, and autoimmune hemolytic anemia. Vomiting has been reported as a presenting feature of Graves' disease. Some cases had the typical findings of hyperthyroidism initially masked, and the vomiting did not improve until hyperthyroidism has been detected and treated. Hyperthyroidism may present with jaundice, and on the other hand, deep jaundice may develop with the onset of overt hyperthyroidism in previously compensated chronic liver disease patients. Pulmonary hypertension is reported to be associated with GD and to respond to its treatment. GD-related pulmonary hypertension may be so severe to produce isolated right-sided heart failure that is occasionally found as the presenting manifestation of GD.

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Hyperthyroidism associated with autoimmune hemolytic anemia and periodic paralysis. A report of a case in which antihyperthroid therapy alone was effective against hemolysis.

Cited by 15 publications

References 2 publications

Successful Remission of Evans Syndrome Associated with Graves' Disease by Using Propylthiouracil Monotherapy

Successful Remission of Evans Syndrome Associated with Graves' Disease by Using Propylthiouracil Monotherapy

Primary Hyperthyroidism Induced Erythropoietin-resistant Anemia?

Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth

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