Stein David A, Twito Orit, Geva Yoav, Sarid Nadav
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Endocrinology, The Edith Wolfson Medical Center, Holon, Israel, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Rambam Maimonides Med J. 2024 Oct 28;15(4):e0021. doi: 10.5041/RMMJ.10535.
Pancytopenia is defined as a reduction in red blood cells, white blood cells, and platelets, and can pose as a diagnostic challenge due to the multitude of causes. Myxedema coma is the manifestation of severe untreated hypothyroidism. This case report presents a rare instance of myxedema coma-associated pancytopenia in a 53-year-old man with a history of untreated hypothyroidism. The patient presented with altered mental status and vital instability, and on further workup was found to have pancytopenia. During his hospital stay his symptomatic hypothyroidism was identified, and he was treated with intravenous levothyroxine, hydrocortisone, and supportive care. The patient's clinical status improved gradually, with normalized blood counts upon discharge. This case underscores the significance of considering myxedema coma in the differential diagnosis of pancytopenia, especially in older patients with limited healthcare access. Increased awareness of this association can aid clinicians in timely diagnosis and management, preventing potential complications associated with untreated hypothyroidism.
全血细胞减少症的定义是红细胞、白细胞和血小板数量减少，由于病因众多，可能构成诊断挑战。黏液性水肿昏迷是严重未治疗的甲状腺功能减退症的表现。本病例报告呈现了一名53岁男性，有未治疗的甲状腺功能减退症病史，出现黏液性水肿昏迷相关全血细胞减少症的罕见病例。患者表现为精神状态改变和生命体征不稳定，进一步检查发现全血细胞减少症。在住院期间，其症状性甲状腺功能减退症得以确诊，并接受了静脉注射左甲状腺素、氢化可的松及支持治疗。患者的临床状况逐渐改善，出院时血细胞计数恢复正常。该病例强调了在全血细胞减少症的鉴别诊断中考虑黏液性水肿昏迷的重要性，尤其是在医疗保健机会有限的老年患者中。提高对这种关联的认识有助于临床医生及时诊断和管理，预防与未治疗的甲状腺功能减退症相关的潜在并发症。
