Hashimoto's thyroiditis and acute chest syndrome revealing sickle cell anemia in a 32 years female patient.
Sickle cell anemia results from a single amino acid substitution in the gene encoding the β-globin subunit. Polymerization of deoxygenated sickle hemoglobin leads to decreased deformability of red blood cells. Hashimoto's thyroiditis is a common thyroid disease now recognized as an auto-immune thyroid disorder, it is usually thought to be haemolytic autoimmune anemia. We report the case of a 32 years old women admitted for chest pain and haemolysis anemia in which Hashimoto's thyroiditis and sickle cell anemia were found. In our observation the patient is a young woman whose examination did not show signs of goitre but the analysis of thyroid function tests performed before an auto-immune hemolytic anemia (confirmed by a high level of unconjugated bilirubin and a Coombs test positive for IgG) has found thyroid stimulating hormone (TSH) and positive thyroid antibody at rates in excess of 4.5 times their normal value. In the same period, as the hemolytic anemia, and before the atypical chest pain and anguish they generated in the patient, the search for hemoglobinopathies was made despite the absence of a family history of haematological disease or painful attacks in childhood. Patient electrophoresis's led to research similar cases in the family. The mother was the first to be analyzed with ultimately diagnosed with sickle cell trait have previously been ignored. This case would be a form with few symptoms because the patient does not describe painful crises in childhood or adolescence.
Hematology and Pediatric Oncology Service, Hospital of August 20 CHU Casablanca, Morocco.
Marielle
M
Igala
Department of Endocrinology, University Hospital Casablanca, Morocco.
Daniela
D
Nsame
Hematology and Pediatric Oncology Service, Hospital of August 20 CHU Casablanca, Morocco.
Jennie Dorothée Guelongo Okouango
JD
Ova
Hematology and Pediatric Oncology Service, Hospital of August 20 CHU Casablanca, Morocco.
Siham
S
Cherkaoui
Laboratory of Hematology, CHU Casablanca, Morocco.
Bouchra
B
Oukkach
Hematology and Pediatric Oncology Service, Hospital of August 20 CHU Casablanca, Morocco.
Asmae
A
Quessar
D056586:Acute Chest Syndrome / Q000175:diagnosis*; D000328:Adult; D000743:Anemia, Hemolytic / Q000175:diagnosis; D000755:Anemia, Sickle Cell / Q000175:diagnosis*; D002637:Chest Pain / Q000209:etiology; D005260:Female; D050031:Hashimoto Disease / Q000175:diagnosis*; D006801:Humans; D013960:Thyroid Function Tests
Hashimoto′s thyroitidis; acute; sickle cell anemia