Les anomalies hématologiques de l’hypothyroïdie

Guizani, Nejib; Mzabi, A.; Sboui, G.; Mkaouar, F.; Rezgui, A.; Anoun, J.; Karmani, M.; Fredj, F. Ben; Laouani, C.

doi:10.1016/j.ando.2018.06.537

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“…In an Algerian study presented at the 34th Congress of the French Society of Endocrinology in 2017, Haddam AEM et al reported a frequency of 6% of leucopenia in their series of 150 untreated hypothyroid patients [21]. The following year, and at the 35th congress of the same society, the Tunisian team of Guizani N et al reported a frequency of 4% of leucopenia in their series of 67 hypothyroid patients [22]. This frequency seems to be very underestimated since in the Kyritsi EM et al study of 218 patients investigated for neutropenia, 95 had a thyroid disorder (43.6%) and half had hypothyroidism [18].…”

Section: Discussionmentioning

confidence: 99%

Isolated non-autoimmune neutropenia revealing primary hypothyroidism

Bouomrani¹,

Rgaïeg²

2019

Blood Heart Circ

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Introduction: hematological disorders are among the so-called unusual manifestations of hypothyroidism, and by far dominated by anemia. Leucocytes abnormalities are less common and often of an autoimmune nature. We report an original case of isolated non-autoimmune neutropenia revealing primary severe hypothyroidism.Case report: A 30-year-old woman was referred by her family doctor for exploration of leucopenia at 3200/mm 3 . Control of the blood count confirmed isolated neutropenia at 600/mm 3 . The other parameters of the total blood count were without abnormalities: hemoglobin at 13g/dl, platelets at 162000/mm 3 , and lymphocytes at 2400/mm 3 . Clinical examination, baseline bioassays, abdominal ultrasonography, thoraco-abdominopelvic CT, and myelogram were without abnormalities. Anti-nuclear, antinative DNA, anti-nucleosome, and anti-neutrophil antibodies were negative.Subsequent investigations concluded to primary hypothyroidism of Hashimoto's thyroiditis: TSH at 182μU/ml, FT4<1 pmol/l, anti-thyroglobulin antibodies at 255 IU/ml, and anti-thyroperoxidase antibodies at 1000 IU/ml. The patient was treated with thyroxine in progressive doses until normalization of TSH with 175μg/d. The evolution was favorable with neutrophils at 2200/mm 3 after one month of treatment. Conclusion:Isolated and non-autoimmune neutropenia indicative of hypothyroidism is exceptional and unusual representing a real diagnostic challenge for clinicians. It is recommended to screen for thyroid dysfunction in front of any leucopenia that does not prove itself.

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Section: Discussionmentioning

confidence: 99%