Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature
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 lit...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/194542 |
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| author | Peyman Naji Geetika Kumar Shabana Dewani William A. Diedrich Ankur Gupta |
| author_facet | Peyman Naji Geetika Kumar Shabana Dewani William A. Diedrich Ankur Gupta |
| author_sort | Peyman Naji |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-c037700b75ec4b7fbaa82739b157895c |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-c037700b75ec4b7fbaa82739b157895c2025-02-03T01:26:27ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/194542194542Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the LiteraturePeyman Naji0Geetika Kumar1Shabana Dewani2William A. Diedrich3Ankur Gupta4Department of Internal Medicine, Dayton Veterans Affair Medical Center, Boonshoft School of Medicine, Wright State University, 4100 West Third Street, Dayton, OH 45428, USADepartment of Hematology and Oncology, Dayton Veterans Affair Medical Center, Boonshoft School of Medicine, Wright State University, 4100 West Third Street, Dayton, OH 45428, USADepartment of Hematology and Oncology, Dayton Veterans Affair Medical Center, Boonshoft School of Medicine, Wright State University, 4100 West Third Street, Dayton, OH 45428, USADepartment of Pathology, Dayton Veterans Affair Medical Center, Boonshoft School of Medicine, Wright State University, 4100 West Third Street, Dayton, OH 45428, USADepartment of Endocrinology and Metabolism, Dayton Veterans Affair Medical Center, Boonshoft School of Medicine, Wright State University, 4100 West Third Street, Dayton, OH 45428, USAGraves’ 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.http://dx.doi.org/10.1155/2013/194542 |
| spellingShingle | Peyman Naji Geetika Kumar Shabana Dewani William A. Diedrich Ankur Gupta Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature Case Reports in Medicine |
| title | Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature |
| title_full | Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature |
| title_fullStr | Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature |
| title_full_unstemmed | Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature |
| title_short | Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature |
| title_sort | graves disease causing pancytopenia and autoimmune hemolytic anemia at different time intervals a case report and a review of the literature |
| url | http://dx.doi.org/10.1155/2013/194542 |
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