Case Report
Volume: 2 | Issue: 3 | Published: Jan 01, 1970 | Pages: 95 - 99 | DOI: 10.24911/ejmcr/173-1534869022
Pancytopenia in an untreated patient with toxic multinodular goiter
Authors:
Agron Ylli
, Violeta Hoxha
, Esmeralda Cela
, Ditila Doracaj
, Gentian Vyshka
, Luljeta Cakerri
Article Info
Authors
Agron Ylli
Service of Endocrinology, University Hospital Center Mother Theresa, Tirana, Albania
Violeta Hoxha
Service of Endocrinology, University Hospital Center Mother Theresa, Tirana, Albania
Esmeralda Cela
Service of Endocrinology, University Hospital Center Mother Theresa, Tirana, Albania
Ditila Doracaj
Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
Gentian Vyshka
Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
Luljeta Cakerri
Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
Publication History
Received: August 21, 2018
Revised: September 10, 2018
Accepted: September 18, 2018
Published: January 01, 1970
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, green
