Nightingale S, Vitek P J, Himsworth R L
Q J Med. 1978 Jan;47(185):35-47.
In an unselected series of 239 patients with uncomplicated hyperthyroidism the haemoglobin concentration was less than 12.0 g/dl in 37 of 207 women and below 13.0 g/dl in 9 of 32 men. Although some of these patients with a low level of haemoglobin were iron deficient, with a transferrin saturation less than 16 per cent, many were not. On treatment of hyperthyroidism the haemoglobin rose by an average of 0.5 g/dl in patients who had not been anaemic on diagnosis. A small fall in haemoglobin is therefore usual in hyperthyroidism and it may sometimes be sufficient to cause a mild degree of anaemia. The mean corpuscular volume (MCV) was decreased in hyperthyroid patients who had neither anaemia nor a reduced transferrin saturation. After treatment of hyperthyroidism the MCV rose in these patients by an average of 6 fl. A dimunition in MCV, even within the normal range, is an invariable concomitant of hyperthyroidism. The administration of thyroxine to excess does not, however, cause the same change in the MCV. On diagnosis of hyperthyroidism the prevalence of pernicious anaemia in this series of patients was 1.9 per cent. Gastric parietal cell antibodies were present in 15.4 per cent and thyroid microsomal antibodies in 49.5 per cent.
在一组未经挑选的239例无并发症的甲状腺功能亢进患者中，207名女性中有37名血红蛋白浓度低于12.0 g/dl，32名男性中有9名低于13.0 g/dl。尽管这些血红蛋白水平低的患者中有些存在缺铁，转铁蛋白饱和度低于16%，但许多患者并非如此。在治疗甲状腺功能亢进时，诊断时无贫血的患者血红蛋白平均升高0.5 g/dl。因此，甲状腺功能亢进时血红蛋白轻度下降很常见，有时可能足以导致轻度贫血。在既无贫血也无转铁蛋白饱和度降低的甲状腺功能亢进患者中，平均红细胞体积（MCV）降低。治疗甲状腺功能亢进后，这些患者的MCV平均升高6 fl。MCV降低，即使在正常范围内，也是甲状腺功能亢进的一个必然伴随现象。然而，过量给予甲状腺素并不会引起MCV的相同变化。在诊断甲状腺功能亢进时，该系列患者中恶性贫血的患病率为1.9%。胃壁细胞抗体阳性率为15.4%，甲状腺微粒体抗体阳性率为49.5%。
