We present the case of a patient with acromegaly who had pancytopenia with hypopituitarism secondary to the excision of a pituitary macroadenoma and radiation therapy. A 28-year-old man presented with pancytopenia and serum electrolyte abnormalities. He was diagnosed with acromegaly and underwent surgery and gamma-knife radiotherapy for a pituitary macroadenoma at the age of 22 years. A recent brain magnetic resonance imaging showed an empty sella, and the basal hormonal profile demonstrated deficiencies of pituitary hormones except thyrotropin. As presenting pancytopenia, his bone marrow biopsy showed hypocellular marrow. The total number of hemocytes increased after hydrocortisone replacement. Hypopituitarism was a possible cause of pancytopenia, and glucocorticoids had crucial effects on converting pancytopenia to normal in this case.
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A 24-Year-Old Male with Gigantism, Growth Hormone Deficiency, Suspected Clivus Chordoma, Primary Hypothyroidism, Hypogonadism and Pancytopenia W.A. Arsana, M.I. Diah Pramudianti INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY.2019; 26(2): 249. CrossRef
Hormones and the Bone Marrow: Panhypopituitarism and Pancytopenia in a Man with a Pituitary Adenoma Dianna Lang, Jennifer S. Mead, David B. Sykes Journal of General Internal Medicine.2015; 30(5): 692. CrossRef
Sheehan's syndrome is characterized by varying degrees of anterior pituitary dysfunction due to postpartum ischemic necrosis of the pituitary gland after massive bleeding. The spectrum of clinical presentation of Sheehan's syndrome is broad, with changes from nonspecific complaints, such as weakness, fatigue, and anemia, to severe pituitary insufficiency resulting in coma and death. Normochromic anemia is commonly associated with Sheehan's syndrome, but pancytopenia is rarely observed in patients with Sheehan's syndrome. We describe a 57-year-old woman with Sheehan's syndrome who presented with pancytopenia that was treated by hormone replacement with levothyroxine and glucocorticoid.
Hematological disorders, and especially single lineage abnormalities, have been described in patients suffering with thyrotoxicosis, but pancytopenia is a rare complication of thyrotoxicosis. Pancytopenia with thyrotoxicosis has been reported to be totally reversible with antithyroid drug treatment. We experienced a case with pancytopenia associated with Graves' disease in a 57-year-old woman who had no specific cause of pancytopenia. She presented with dyspnea and palpitation. The laboratory findings revealed thyrotoxicosis and pancytopenia. Increased radioisotope uptake was seen on the thyroid scan and normal cellularity and maturation were found in the bone marrow aspiration biopsy. Based on these findings, she was diagnosed as suffering from Gravesyendisease with pancytopenia. After treatment with propylthiouracil, the blood cell counts were restored to normal as the patient achieved a euthyroid state. We report here on a case of Graves' disease that was complicated by pancytopenia, and all this was normalized after treatment for hyperthyroidism.
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Non-myeloproliferative Pancytopenia: A Rare Presentation of Thyrotoxicosis Izzathunnisa Rahmathullah, Maheswaran Umakanth, Suranga Singhapathirane Cureus.2023;[Epub] CrossRef
Pancytopenia in a surgical patient, a rare presentation of hyperthyroidism Prabhat Jha, Yogendra Prasad Singh, Bikal Ghimire, Binit Kumar Jha BMC Surgery.2014;[Epub] CrossRef
A Case of Pancytopenia with Hyperthyroidism Tae Hoon Kim, Ji Sung Yoon, Byung Sam Park, Dong Won Lee, Jae Ho Cho, Jun Sung Moon, Eui Hyun Kim, Kyu Chang Won, Hyoung Woo Lee Yeungnam University Journal of Medicine.2013; 30(1): 47. CrossRef
Methimazole has remained the cornerstone for the treatment of hyperthyroidism since 1940's and it is a well-tolerated antithyroid drug. Pancytopenia is one of the major side effects of methimazole, but its occurrence is very rare. There have been some case reports about methimazole-induced pancytopenia that was treated with recombinant human granulocyte colony-stimulating factor (G-CSF), but its usefulness is still controversial. We present here a case of a 50-year-old female who had been treated with methimazole for hyperthyroidism and she subsequently presented pancytopenia. G-CSF was given for 10 days and she successfully recovered from the pancytopenia.
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A Case of Graves' Disease with Pancytopenia Jong Ho Shin, Hyun Jin Kim, Si Bum Kim, Dong Pil Kim, Bong Suk Ko, Dong Soon Kim, Ji Myung Kim, Soo Jung Gong, Jung-Ae Lee Journal of Korean Endocrine Society.2009; 24(4): 272. CrossRef
Postpartum ischemic necrosis of the pituitary gland, known as Sheehan's syndrome, is well- established clinical entity. In anterior pituitary insufficiency, there is very often a normochromic or hypochromic anemia but pancytopenia secondary to the hypopituitarism is less common. We report a case of pancytopenia due to complete aplasia of the bone marrow associated with Sheehan's syndrome, in which hormone replacement therapy alone produced full hematological recovery.