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Type: Artigo de periódico
Title: Pancytopenia in untreated patients with Graves' disease
Author: Lima, CSP
Wittmann, DEZ
Castro, V
Tambascia, MA
Lorand-Metze, I
Saad, STO
Costa, FF
Abstract: Severe pancytopenia is a rare but severe complication of thyrotoxicosis. In this report, we describe four patients with Graves' disease who presented with pancytopenia at diagnosis. Methimazole (30-40 mg/d) or propylthiouracil (400 mg/d) restored normal hematopoiesis in three of the patients. The remaining patient evolved to aplastic anemia under therapy with methimazole (60 mg/d), but had an increased peripheral blood count that almost reached normal values after radioiodinetherapy and standard immunosuppressive treatment with antithymocyte globulin (700 mg/d, intravenous infusion for 5 days), oral cyclosporin (400 mg/d), prednisone (30-60 mg/d), and granulocyte colony-stimulating factor (150 mu g subcutaneous injection, 3 times per week). We conclude that: (1) a hematologic evaluation of all patients with Graves' disease should be performed before administering antithyroid drugs, (2) antithyroid drugs may be administered to patients with pancytopenia and bone marrow hypercellularity but a reevaluation of the bone marrow must be done if there is no recovery of the peripheral blood cell count when euthyroidism state is acheived, (3) standard immunosuppressive treatment of aplastic anemia caused by antithyroid drugs restores normal hematopoiesis, and (4) a thyroid evaluation of patients with pancytopenia should be done, even though no related symptoms are found.
Country: EUA
Editor: Mary Ann Liebert Inc
Citation: Thyroid. Mary Ann Liebert Inc, v. 16, n. 4, n. 403, n. 409, 2006.
Rights: embargo
Identifier DOI: 10.1089/thy.2006.16.403
Date Issue: 2006
Appears in Collections:Unicamp - Artigos e Outros Documentos

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