PANCYTOPENIA AND LYMPHOID ORGAN HYPERPLASIA IN A PATIENT WITH GRAVES DISEASE: RESPONSE TO ANTITHYROID DRUG THERAPY

Area of Science:

• Endocrinology
• Hematology
• Immunology

Background:

• Cytopenias, particularly pancytopenia, are uncommon complications of thyrotoxicosis.
• Graves disease (GD) is a common cause of thyrotoxicosis, but its association with pancytopenia is rare.

Observation:

• A 35-year-old male presented with pancytopenia and symptoms of infection.
• Extensive workup, including bone marrow analysis and imaging, revealed thymic hyperplasia and splenomegaly.
• Thyroid function tests confirmed thyrotoxicosis with elevated thyroid-stimulating immunoglobulin, consistent with Graves disease.

Findings:

• The patient's pancytopenia resolved following treatment with antithyroid medication.
• Radioactive iodine therapy (131-iodine) provided definitive treatment for Graves disease.
• Follow-up revealed normalization of blood cell counts.

Implications:

• This case highlights that Graves disease should be considered in the differential diagnosis of pancytopenia, especially when accompanied by lymphoid organ hyperplasia.
• Early diagnosis and appropriate management of thyrotoxicosis are crucial for resolving associated hematological complications.