Kim Dae-Young, Kim Jee Hyun, Park Young Joo, Jung Kyung Hae, Chung Hee Sun, Shin Soo, Yun Sung-Soo, Park Seonyang, Kim Byoung Kook
Department of Internal Medicine, Seoul National University College of Medicine, Yongon-dong, Jongro-gu, 110-744, Seoul, Korea.
Ann Hematol. 2004 May;83(5):309-12. doi: 10.1007/s00277-003-0800-4. Epub 2003 Nov 26.
We describe a 55-year-old woman who presented with pancytopenia with a normocytic and normochromic anemia which was progressive despite conventional treatments such as folic acid, vitamin B6, and oxymetholone. Her physical findings and history of a previous massive postpartum hemorrhage suggested Sheehan's syndrome, and the pituitary hormonal studies revealed panhypopituitarism. After 4 months of thyroxine and glucocorticoid replacement therapy, her pancytopenia and bone marrow hypoplasia recovered completely. Pancytopenia is a rare manifestation of a hormonal abnormality, but hematologists need to be aware of panhypopituitarism as a differential diagnosis when women showing features of hypopituitarism present with pancytopenia because it can be reversed with adequate hormone replacement.
我们描述了一名55岁女性，她出现全血细胞减少，伴有正细胞正色素性贫血，尽管接受了叶酸、维生素B6和羟甲烯龙等常规治疗，但病情仍在进展。她的体格检查结果以及既往大量产后出血史提示希恩综合征，垂体激素检查显示全垂体功能减退。经过4个月的甲状腺素和糖皮质激素替代治疗，她的全血细胞减少和骨髓发育不全完全恢复。全血细胞减少是激素异常的一种罕见表现，但血液科医生需要意识到，当出现垂体功能减退特征的女性伴有全血细胞减少时，全垂体功能减退是一种鉴别诊断，因为通过适当的激素替代治疗，病情可以逆转。
