A Case of Hyperthyroidism with Pancytopenia and the Etiological Study of Its Haematological Disorders

Abstract

A case of hyperthyroidism with pancytopenia has been experienced in our clinic.
A 47-year-old female was noticed icterus and splenomegaly. Haematologic examina tions revealed hyperchromic anemia and remarkable increasing of polychromatophilic normoerythroblasts in the bone marrow. Erythrocyte survival was markedly shortened and the uptake of iron into erythrocytes was reduced. The uptake of radioactive iron into the bone marrow was also reduced. Osmotic fragility of erythrocytes was within normal limit and Coombs' test, antileucocytic antibody and antithrombocytic antibody were negative respectively.
This case showed no sign of hyperthyroidism, however no abnormality was found except hyperthyroidism in laboratory findings, so that etiology of anemia was thought to be due to hyperthyroidism. Then, methimazole was given. Two months after the administration, whole blood cell components became gradually increased and these values showed to be normal limit 6 months after the administration of methimazole. In this period, no other drug was given.
As to the etiology of anemia, the combination of hemolysis and ineffective erythropoiesis could be thought and splenomegaly might be related to the reduction of leucocytes and thrombocytes.