A Rare Case Of Graves’ Disease With Splenomegaly And Pancytopenia

  • Elayne Christinne Marcelino e Silva
  • Settings Ricardo Parente Garcia Vieira
  • Maria Misrelma Moura Bessa ABC College of Medicine, Study Design Lab an Scientific
  • Joao Kennedy Teixeira Lima
  • Thyciara Fontenele Marques Faculdade de Medicina Estácio de Juazeiro do Norte

Abstract

Introduction: Splenomegaly and pancytopenia are rare complications of Graves' disease with few reports in the literature about this association. The pathogenesis is unknown and immunological mechanisms seem to be involved. The possibility of hyperthyroidsm should always considered in patients with pancytopenia.


Objective: Describe  clinical case of association between Grave's disease, splenomegaly and pancytopenia.


Method: This is a case report, obtained through data from medical records of a reference hospital located in the city of Juazeiro do Norte, Ceara, Brazil. Case report: Patient, 46 years old, female, sought treatment at a reference hospital with abdominal pain that started two days earlier, prevalent in mesogastric region and left hypochondrium very intense and recurrent, associated with significant consuptive syndrome ( loss of 10 Kg in 4 months), asthenia, dyspnea on minimum exertion, irritability and fine tremor in extremitie. SHe denied fever, palpitations, heat intolerance, skin ou eye changes. A diffuse thyroid enlargement with the presence of thrill and murmur, digital clubbing, fixed and bright look, light exophthalmos and splenomegaly about 6 cm below the left costal margin were abserved after physical examination. Ultrasound examination (USG) of the abdomen and CT scan showed moderate splenomegaly. Laboratory tests showed normocytic and normochromic anemia, leukocytosis and mild thrombocytopenia. Thyroid USG showed characteristic features of Graves' disease, a bone marrow biopsy revealed maturation preserved in all strains and lack of fibrosis and megakaryocytes present in normal number without atypia. treatment was set with propylthiouracil 300 mg a day and after the first revaluation after hospital discharge three weeks later a regression of splenomegaly has been observed.


Conclusion: This case ilustrates the rare association between hyperthyroidism and splenomegaly with pancytopenia.


 

Author Biography

Joao Kennedy Teixeira Lima

Universidade Federal De Campina Grande
Faculdade De Medicina Do ABC
Faculdade De Medicina De Juazeiro Do Norte
Centro De Nefrologia De Juazeiro Do Norte
Terapia Renal Do Cariri Ltda

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Published
2017-07-07
How to Cite
MARCELINO E SILVA, Elayne Christinne et al. A Rare Case Of Graves’ Disease With Splenomegaly And Pancytopenia. International Archives of Medicine, [S.l.], v. 10, july 2017. ISSN 1755-7682. Available at: <http://imedicalsociety.org/ojs/index.php/iam/article/view/2714>. Date accessed: 24 sep. 2017. doi: https://doi.org/10.3823/2446.
Section
Endocrinology