Background: Chronic, autoimmune thyroid diseases are sometimes combined with autoimmune hematologic diseases, such as pernicious anemia, autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenic purpura (ITP). Hashimoto thyroiditis is one of the most common autoimmune diseases.
Case report: seventeen years old female adolescent complaining of delayed puberty and short stature. She is a known case of autoimmune hemolytic anemia diagnosed at age of ten years old and was on corticosteroids for four years till she underwent splenctomy after which she was controlled with no medications other than long acting pencillin monthly. Her examination revealed goiter so thyroid function tests were done including autoantibodies and ultrasonography (U/S) neck, surprisingly her result was TSH: 232 uIU/ml Normal range (N.)(0.76), free T4: 0.21 ng/dl (N. 0.92), anti-peroxidase: more than 600 U/ml (N.up to 43), anti-thyroglobulin antibody: more than 4000 U/ml (N. up to 115) and U/S features suggestive of thyroiditis. One month later after starting Eltroxin, she had her first menses also her laboratory follow up results improved dramatically. Assessment of other autoimmune associations as Celiac disease, Addisons disease and type 1 diabetes were negative.
Conclusion: we concluded that Patients with autoimmune hematological diseases should be evaluated by thyroid function tests, including those for thyroid auto-antibodies, to prevent the development of overt hypo- or hyperthyroidism and other autoimmune diseases.
27 Sep 2018 - 29 Sep 2018