Pancytopenia in an untreated patient with toxic multinodular goiter
Authors: Agron Ylli, Violeta Hoxha, Esmeralda Cela, Ditila Doracaj, Gentian Vyshka, Luljeta Cakerri
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
Authors
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
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
Ylli A, Hoxha V, Cela E, Doracaj D, Vyshka G, Cakerri L. Pancytopenia in an untreated patient with toxic multinodular goiter. https://www.ejmcr.com/?mno=5128 [Access: April 24, 2024]. doi:
10.24911/ejmcr/173-1534869022
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
Ylli A, Hoxha V, Cela E, Doracaj D, Vyshka G, Cakerri L. Pancytopenia in an untreated patient with toxic multinodular goiter. EJMCR. (2018), [cited April 24, 2024]; 2(3): 95-99. doi:
10.24911/ejmcr/173-1534869022
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
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
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
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
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