Pancytopenia related to Graves’ disease

Hegazi, Mohamed Osama; Kumar, Ramesh; Bitar, Zouheir; Eman, Ibrahim

doi:10.5144/0256-4947.2008.48

Cited by 10 publications

(21 citation statements)

References 5 publications

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“…One study showed that lower platelet count is metabolically mediated, while another study showed the presence of antiplatelet antibodies in 50% of patients with Graves' disease . There are also several case reports of patients presenting with pancytopenia in Graves' disease …”

Section: Discussionmentioning

confidence: 99%

“…26 There are also several case reports of patients presenting with pancytopenia in Graves' disease. [27][28][29][30] The strengths of this study are the relatively large sample size, systematic measurement of haematological and biochemical parameters and robust collection of additional demographic and clinical data. This study also has a number of limitations.…”

Section: Discussionmentioning

confidence: 99%

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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: 99%

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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“…Based on these observations both hyperthyroidism and autoimmunity contribute to the pathogenesis of pancytopenia in GD patients. Bone marrow biopsy can be hypercellular [ 14 , 15 ] or normocellular [ 17 , 19 ] (like our patient) and theories such as organ sequestration, decreased peripheral circulation times, stem cell dysfunction, and nutritional deficiencies have been suggested.…”

Section: Discussionmentioning

confidence: 95%

“…Pancytopenia in the setting of hyperthyroidism has also been reported in a handful of cases in the literature. Most cases have been associated with Graves' disease [ 14 – 17 ] and one case with toxic adenoma [ 18 ]. In one case report, the patient had pancytopenia as a result of both endogenous and exogenous thyroid hormone excess at different time intervals [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Using these in a patient with pancytopenia can be challenging. However, the published cases in the literature have almost universally responded well to treatment with these medications, and reaching euthyroid status has been the key for correction of the hematologic abnormality [ 14 – 19 ]. This has also been true in cases of patients with autoimmune hemolytic anemia and Evan's syndrome [ 8 – 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature

Naji

Kumar

Dewani

et al. 2013

Case Reports in Medicine

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Graves' disease (GD) is associated with various hematologic abnormalities but pancytopenia and autoimmune hemolytic anemia (AIHA) are reported very rarely. Herein, we report a patient with GD who had both of these rare complications at different time intervals, along with a review of the related literature. The patient was a 70-year-old man who, during a hospitalization, was also noted to have pancytopenia and elevated thyroid hormone levels. Complete hematologic workup was unremarkable and his pancytopenia was attributed to hyperthyroidism. He was started on methimazole but unfortunately did not return for followup and stopped methimazole after a few weeks. A year later, he presented with fatigue and weight loss. Labs showed hyperthyroidism and isolated anemia (hemoglobin 7 g/dL). He had positive direct Coombs test and elevated reticulocyte index. He was diagnosed with AIHA and started on glucocorticoids. GD was confirmed with elevated levels of thyroid stimulating immunoglobulins and thyroid uptake and scan. He was treated with methimazole and radioactive iodine ablation. His hemoglobin improved to 10.7 g/dL at discharge without blood transfusion. Graves' disease should be considered in the differential diagnosis of hematologic abnormalities. These abnormalities in the setting of GD generally respond well to antithyroid treatment.

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Graves' disease with pancytopenia: A rare case report

Meftah,

Sedaghat,

Rabizadeh

et al. 2024

Clinical Case Reports

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Key Clinical MessageIn this case report we describe a patient with Grave's disease (GD) who was first diagnosed with pancytopenia and did not have any typical symptoms of GD. His hematologic abnormalities were alleviated after treatment with an anti‐thyroid drug. Hence, in patients with pancytopenia, GD should also be considered.AbstractA variety of hematologic abnormalities can be seen in Graves' disease (GD), however; here, we describe a patient with GD and a very rare complication; pancytopenia. His hematologic abnormalities and clinical status were alleviated after treatment with an anti‐thyroid drug. Hence, in patients with pancytopenia and normal bone marrow examination, GD should also be considered.

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Pancytopenia related to Graves’ disease

Cited by 10 publications

References 5 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

Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature

Graves' disease with pancytopenia: A rare case report

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