EJMCR. 2018; 2(3): 95-99

Pancytopenia in an untreated patient with toxic multinodular goiter

Authors: Agron Ylli, Violeta Hoxha, Esmeralda Cela, Ditila Doracaj, Gentian Vyshka, Luljeta Cakerri.

ABSTRACT

Background: Thyroid abnormalities may be the cause of unexplained pancytopenia. Routine hematologic evaluation should be performed before administration of anti-thyroid drugs in cases of clinical hyperthyroidism, to clarify any occurrence of unexplained pancytopenia. Case Presentation: An 82-year-old woman presented to the emergency department with general weakness, palpitations, excessive sweating, and weight loss. A complete work-up suggested the existence of hyperthyroidism due to toxic multinodular goiter with depletion of all three cell lines in peripheral blood count. Abdominal ultrasonogram showed no abnormal findings, including hepatosplenomegaly. Normocellular marrow was noted in bone marrow aspiration and biopsy. Conclusion: A combined drug therapy with methimazole 30 mg/day, parenteral dexamethasone 8 mg/day, beta-blockers, and digoxin was administered to the patient. Free Triiodothyronine (FT3) and Free Thyroxine (FT4) levels decreased gradually and pancytopenia improved within 2 weeks of treatment.

Keywords:
Goiter, pancytopenia, thyroid disease, case report


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Pancytopenia in an untreated patient with toxic multinodular goiter


Authors
Agron Ylli
Service of Endocrinology, University Hospital Center Mother Theresa, Tirana, Albania
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Violeta Hoxha
Service of Endocrinology, University Hospital Center Mother Theresa, Tirana, Albania
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Esmeralda Cela
Service of Endocrinology, University Hospital Center Mother Theresa, Tirana, Albania
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Ditila Doracaj
Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
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Gentian Vyshka
Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
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Luljeta Cakerri
Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
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Correspondence to:
. Gentian Vyshka, Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania ; gvyshka@gmail.com

Publication history
Received 21 Aug 2018
Revised 10 Sep 2018
Accepted 18 Sep 2018
Published in print 12 Oct 2018

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Pubmed Style

Ylli A, Hoxha V, Cela E, Doracaj D, Vyshka G, Cakerri L. Pancytopenia in an untreated patient with toxic multinodular goiter. EJMCR. 2018; 2(3): 95-99. doi:10.24911/ejmcr/173-1534869022


Web Style

Ylli A, Hoxha V, Cela E, Doracaj D, Vyshka G, Cakerri L. Pancytopenia in an untreated patient with toxic multinodular goiter. http://www.ejmcr.com/?mno=5128 [Access: November 15, 2018]. doi:10.24911/ejmcr/173-1534869022


AMA (American Medical Association) Style

Ylli A, Hoxha V, Cela E, Doracaj D, Vyshka G, Cakerri L. Pancytopenia in an untreated patient with toxic multinodular goiter. EJMCR. 2018; 2(3): 95-99. doi:10.24911/ejmcr/173-1534869022


Vancouver/ICMJE Style

Ylli A, Hoxha V, Cela E, Doracaj D, Vyshka G, Cakerri L. Pancytopenia in an untreated patient with toxic multinodular goiter. EJMCR. (2018), [cited November 15, 2018]; 2(3): 95-99. doi:10.24911/ejmcr/173-1534869022


Harvard Style

Ylli, A., Hoxha, . V., Cela, . E., Doracaj, . D., Vyshka, . G. & Cakerri, . L. (2018) Pancytopenia in an untreated patient with toxic multinodular goiter. EJMCR, 2 (3), 95-99. doi:10.24911/ejmcr/173-1534869022


Turabian Style

Ylli, Agron, Violeta Hoxha, Esmeralda Cela, Ditila Doracaj, Gentian Vyshka, and Luljeta Cakerri. 2018. Pancytopenia in an untreated patient with toxic multinodular goiter. European Journal of Medical Case Reports, 2 (3), 95-99. doi:10.24911/ejmcr/173-1534869022


Chicago Style

Ylli, Agron, Violeta Hoxha, Esmeralda Cela, Ditila Doracaj, Gentian Vyshka, and Luljeta Cakerri. "Pancytopenia in an untreated patient with toxic multinodular goiter." European Journal of Medical Case Reports 2 (2018), 95-99. doi:10.24911/ejmcr/173-1534869022


MLA (The Modern Language Association) Style

Ylli, Agron, Violeta Hoxha, Esmeralda Cela, Ditila Doracaj, Gentian Vyshka, and Luljeta Cakerri. "Pancytopenia in an untreated patient with toxic multinodular goiter." European Journal of Medical Case Reports 2.3 (2018), 95-99. Print. doi:10.24911/ejmcr/173-1534869022


APA (American Psychological Association) Style

Ylli, A., Hoxha, . V., Cela, . E., Doracaj, . D., Vyshka, . G. & Cakerri, . L. (2018) Pancytopenia in an untreated patient with toxic multinodular goiter. European Journal of Medical Case Reports, 2 (3), 95-99. doi:10.24911/ejmcr/173-1534869022


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