一例伴有全血细胞减少的甲状腺毒症病例。

A case of thyrotoxicosis with pancytopenia.

作者信息

Soeki T, Tamura Y, Kondo N, Shinohara H, Tanaka H, Bando K, Fukuda N

机构信息

Department of Internal Medicine and Clinical Research, National Zentsuji Hospital, Kagawa, Japan.

出版信息

Endocr J. 2001 Jun;48(3):385-9. doi: 10.1507/endocrj.48.385.

DOI:10.1507/endocrj.48.385

PMID:11523911

Abstract

We report a 49-year-old man with primary hyperthyroidism who presented with pancytopenia. The patient presented with leg edema, sinus tachycardia, cardiomegaly, and pleural effusions, all from congestive heart failure. Laboratory data showed pancytopenia and primary hyperthyroidism; echocardiogram showed diffuse hyperkinesis of the left ventricular wall and right ventricular overloading. The bone marrow was moderately hypercellular and compatible with arrested hematopoiesis. Pancytopenia and heart failure improved after administration of methimazole and diuretics. However, high levels of thyroid hormone recurred with pancytopenia 4 months after admission. Therefore, subtotal thyroidectomy was performed, and the levels of thyroid hormones and peripheral blood cell counts have remained normal. Pancytopenia may be caused by hyperthyroidism.

摘要

我们报告一名49岁的原发性甲状腺功能亢进症男性患者，其出现全血细胞减少。患者表现为腿部水肿、窦性心动过速、心脏扩大和胸腔积液，均由充血性心力衰竭引起。实验室数据显示全血细胞减少和原发性甲状腺功能亢进症；超声心动图显示左心室壁弥漫性运动增强和右心室负荷过重。骨髓细胞中度增多，与造血停滞相符。服用甲巯咪唑和利尿剂后，全血细胞减少和心力衰竭有所改善。然而，入院4个月后，甲状腺激素水平再次升高并伴有全血细胞减少。因此，进行了甲状腺次全切除术，甲状腺激素水平和外周血细胞计数一直保持正常。全血细胞减少可能由甲状腺功能亢进症引起。