title: A case of thyrotoxicosis with pancytopenia.
abstract: We report a 49-year-old man with primary hyperthyroidism who presented with pancytopenia. The patient presented with leg edema, sinus tachycardia, cardiomegaly, and pleural effusions, all from congestive heart failure. Laboratory data showed pancytopenia and primary hyperthyroidism; echocardiogram showed diffuse hyperkinesis of the left ventricular wall and right ventricular overloading. The bone marrow was moderately hypercellular and compatible with arrested hematopoiesis. Pancytopenia and heart failure improved after administration of methimazole and diuretics. However, high levels of thyroid hormone recurred with pancytopenia 4 months after admission. Therefore, subtotal thyroidectomy was performed, and the levels of thyroid hormones and peripheral blood cell counts have remained normal. Pancytopenia may be caused by hyperthyroidism.
authors.affiliation: Department of Internal Medicine and Clinical Research, National Zentsuji Hospital, Kagawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Soeki
authors.forename: Y
authors.initials: Y
authors.lastname: Tamura
authors.forename: N
authors.initials: N
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Shinohara
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Bando
authors.forename: N
authors.initials: N
authors.lastname: Fukuda
mesh_terms: D013956:Antithyroid Agents / Q000627:therapeutic use; D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D006332:Cardiomegaly / Q000150:complications; D004232:Diuretics / Q000627:therapeutic use; D004487:Edema / Q000150:complications; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007866:Leg; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D008875:Middle Aged; D010198:Pancytopenia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010996:Pleural Effusion; D012008:Recurrence; D013616:Tachycardia, Sinus / Q000150:complications; D013965:Thyroidectomy; D013971:Thyrotoxicosis / Q000150:complications* / Q000473:pathology / Q000628:therapy
chemical_list: D013956:Antithyroid Agents; D004232:Diuretics; D008713:Methimazole