Das Chanchal, Sahana Pranab K, Sengupta Nilanjan, Giri Debasis, Roy Mukut, Mukhopadhyay Prasanta
Department of Endocrinology, N.R.S Medical College and Hospital, Kolkata, India .
Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S361-3. doi: 10.4103/2230-8210.104093.
The association of anemia with primary hypothyroidism has been common knowledge for many years. However; its pathogenesis is far from clear in many cases. Often the causes of anemia are manifold.
In this study, we evaluated the causes of anemia in patients with primary hypothyroidism.
Sixty adult nonpregnant untreated primary hypothyroid patients with anemia without any obvious cause were included. All patients were subjected to full medical history, clinical examination, biochemical and imaging studies. Serum iron profile, vitamin B12, folic acid, anti parietal cell antibody, anti TPO antibody, bone marrow study, and stool for occult blood, Coomb's test, HPLC for hemoglobinopathies and complete hemogram with reticulocyte count were done and analyzed.
Normocytic, normochromic anemia was present in 31 patients (51.6%) followed by microcytic anemia in 26 patients (43.3%). Six patients (10%) had megaloblastic anemia with vitamin B12 deficiency including 3 cases of pernicious anemia. Two patients had combined deficiency of iron and vitamin B12.
Normocytic normochromic anemia with normal bone marrow was commonest type of anemia in this study, followed by iron deficiency anemia.
多年来,贫血与原发性甲状腺功能减退之间的关联已为人所熟知。然而,在许多情况下,其发病机制仍远未明确。贫血的原因往往是多方面的。
在本研究中,我们评估了原发性甲状腺功能减退患者贫血的原因。
纳入60例成年未孕、未经治疗的原发性甲状腺功能减退且无明显原因的贫血患者。所有患者均接受了完整的病史采集、临床检查、生化及影像学检查。检测并分析了血清铁指标、维生素B12、叶酸、抗壁细胞抗体、抗甲状腺过氧化物酶抗体、骨髓检查、大便潜血、库姆斯试验、血红蛋白病的高效液相色谱法以及全血细胞计数和网织红细胞计数。
31例患者(51.6%)存在正细胞正色素性贫血,其次是26例患者(43.3%)出现小细胞性贫血。6例患者(10%)患有维生素B12缺乏所致的巨幼细胞贫血,其中包括3例恶性贫血。2例患者存在铁和维生素B12联合缺乏。
本研究中,骨髓正常的正细胞正色素性贫血是最常见的贫血类型,其次是缺铁性贫血。