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[全血细胞减少症经甲状腺功能亢进症治疗后缓解]

[Pancytopenia resolved by the treatment of hyperthyroidism].

作者信息

Duquenne M, Lakomsky D, Humbert J C, Hadjadj S, Weryha G, Leclère J

机构信息

Clinique médicale et endocrinologique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre-les-Nancy.

出版信息

Presse Med. 1995;24(17):807-10.

PMID:7630870
Abstract

Hyperthyroidism can be associated with various haematological disorders related to several mechanisms. These disorders might be related to the reduced life-span of whole blood components and/or to an autoimmune mechanism. Only one case of pancytopenia has yet been reported. The observation of 3 new personal cases (1 toxic adenoma and 2 Graves' disease) led us to review the pathogeny of haematological disorders found in hyperthyroidism. Only one patient had antineutrophil autoantibodies. Direct and indirect Coomb's test, and Dixon's test were negative. In all patients, bone marrow aspiration was unable to demonstrate pernicious anaemia or myelodysplastic syndrome. Two patients presented cytological signs of macrophage activation with eosinophilia. These cytological features were compatible with an immuno-allergy mechanism. All haematological disorders disappeared when patients became euthyroid. In all cases, the haematological abnormalities were quite mild and might have gone unnoticed. Thus, it can be suggested that the frequency of pancytopenia in hyperthyroidism is underestimated.

摘要

甲状腺功能亢进症可能与多种血液系统疾病相关,这些疾病涉及多种机制。这些疾病可能与全血成分寿命缩短和/或自身免疫机制有关。目前仅报道过1例全血细胞减少症。对3例新的个人病例(1例毒性腺瘤和2例格雷夫斯病)的观察促使我们重新审视甲状腺功能亢进症中血液系统疾病的发病机制。仅1例患者存在抗中性粒细胞自身抗体。直接和间接库姆斯试验以及狄克逊试验均为阴性。所有患者的骨髓穿刺均未显示恶性贫血或骨髓增生异常综合征。2例患者出现伴有嗜酸性粒细胞增多的巨噬细胞活化的细胞学迹象。这些细胞学特征与免疫过敏机制相符。患者甲状腺功能恢复正常后,所有血液系统疾病均消失。在所有病例中,血液学异常都相当轻微,可能未被注意到。因此,可以认为甲状腺功能亢进症中全血细胞减少症的发生率被低估了。

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