Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jun 25:11:1179547618781090.
doi: 10.1177/1179547618781090. eCollection 2018.

Graves Disease Causing Pancytopenia: Case Report and Literature Review

Laurence Pincet  1 , François Gorostidi  1
Affiliations
Case Reports

Graves Disease Causing Pancytopenia: Case Report and Literature Review

Laurence Pincet et al. Clin Med Insights Case Rep. .

Abstract

Background: Graves disease or other causes of thyrotoxicosis are frequently associated with cytopenia. Although anemia is the most common, other cell lineage can be affected. Pancytopenia is a rare complication of thyrotoxicosis.

Case presentation: We report a case of a 33-year-old Chinese man who presented a nonsevere pancytopenia in the context of a newly diagnosed Graves disease. Restauration of euthyroid state led to progressive correction of pancytopenia.

Conclusions: Literature review shows other rare cases of pancytopenia. It is usually nonsevere with just extremely rare cases of transfusion reported. Evolution was always favorable after achievement of euthyroid state. Its mechanism remains poorly understood, especially because those patients have no vitamin or iron deficiency. The exact physiopathological process remains unclear but 2 causes seem to overlap: reduced production of hematopoietic cells from the bone marrow and increased destruction or sequestration of mature hematopoietic cells. Despite unclear mechanism, the presence of hematologic abnormalities including pancytopenia must not be considered as a contraindication to antithyroid drug therapy.

Keywords: Graves disease; antithyroid drug therapy; hyperthyroidism; pancytopenia.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Kim TH, Yoon JS, Park BS, et al. A case of pancytopenia with hyperthyroidism. YUJM. 2013;30:47–50.
    1. Naji P, Kumar G, Dewani S, Diedrich WA, Gupta A. Grave disease causing pancytopenia and autoimmune hemolytic anemia at different time intervals: a case report and a review of the literature. Case Rep Med. 2013;2013:194542. - PMC - PubMed
    1. Lima CS, Wittmann DE, Catro V, et al. Pancytopenia in untreated patients with Graves’ disease. Thyroid. 2006;16:403–409. - PubMed
    1. Rafhati AN, See CK, Hoo FK, Badrulnizam LBM. A report of three cases of untreated Graves’ disease associated with pancytopenia in Malaysia. Electron Physician. 2014;6:877–882. - PMC - PubMed
    1. Raina S, Kaul R, Mruthyunjaya M. Pancytopenia with cellular bone marrow related to Graves’ hyperthyroidism. Indian J Endocrinol Metab. 2012;16:478–479. - PMC - PubMed

Publication types