Hypothyroidism Associated with Myeloid Neoplasia

Area of Science:

• Hematology
• Endocrinology
• Oncology

Background:

• Hypothyroidism can present with hematological disturbances like macrocytic anemia.
• Thyroid hormone replacement therapy typically corrects these hematological abnormalities.
• Persistent hematological issues despite treatment warrant further investigation.

Purpose of the Study:

• To report two cases where hypothyroidism-associated hematological disturbances were refractory to thyroid hormone replacement.
• To investigate the underlying causes of persistent hematological abnormalities in these patients.
• To discuss the rare co-occurrence of hypothyroidism and myeloid malignancies.

Main Methods:

• Case report of two patients with hypothyroidism and persistent hematological disturbances.
• Review of diagnostic workup including peripheral blood counts and bone marrow examination.
• Analysis of treatment response to thyroid hormone replacement therapy.

Main Results:

• Two patients with hypothyroidism presented with macrocytic anemia, and one also had leukopenia and thrombocytopenia.
• Thyroid hormone replacement failed to resolve the hematological abnormalities in both cases.
• Further investigations revealed acute myeloid leukemia (AML) in one patient and myelodysplastic syndrome (MDS) in the other.

Conclusions:

• Persistent hematological disturbances in hypothyroidism, unresponsive to treatment, may indicate an underlying myeloid malignancy.
• The association between hypothyroidism and AML/MDS in these cases is likely coincidental.
• Early recognition and comprehensive investigation are crucial for diagnosing rare co-existing conditions.