Case Report

Myxedema Coma Complicated by Pancytopenia

Table 2

Some reported cases of pancytopenia associated with hypothyroidism found in the literature [46, 8, 10, 11].

Author(s)AgeSexPresentationCell countTreatmentOutcome

McMahon and Kamath [11]25FKnown hypothyroidism, iron deficiency anemia, fatigue, weight lossWBC 3800/µLLevothyroxine + vitamin B12Complete resolution of pancytopenia on 2-month follow-up
Hemoglobin 6.9 g/dL
Platelet 158 × 109/L
Rathi and Peacey [6]64FNo past medical history, 4-week history of bilateral leg swelling, tiredness, dry skinWBC 2900/µLLevothyroxineComplete resolution of proteinuria and pancytopenia on 3-month follow-up after discharge
Hemoglobin 10.2 g/dL
Platelet 127 × 109/L (150–400)
Tsoukas [4]82FConfusion, lethargy, bradycardia, hypothermia, respiratory stridor, no past medical historyWBC 3990/µLIV hydrocortisone + IV levothyroxine, subsequent PO levothyroxine on dischargeComplete resolution of pancytopenia on 4-week follow-up after discharge
Hemoglobin 8.5 g/dL,
Platelet 27 × 109/L
Song et al. [8]68FIncreasing immobility over 12 months, alopecia, drowsy, slurred speech, deep voice, no other past medical historyWBC 1600/µLIV hydrocortisone + IV triiodothyronine, oral levothyroxine replacement 1 week laterResolution of white cell count and platelet count at 6 weeks on discharge
Improved hemoglobin at 4-month follow-up after discharge
Hemoglobin 8.2 g/dL
Platelet 35 × 109/L
Lee AC [5], letter to the editor11FPatient developed postablative hypothyroidism and pancytopenia after radiotherapy for suprasellar germinomaAbsolute neutrophil 0Packed red blood cell and platelet transfusions, thyroxine replacement + hormonal replacementPancytopenia resolved within a week of thyroid hormone replacement
Hemoglobin 6.9 g/dL
Platelet 8 × 109/L
Shaaban et al. [10]57FRestlessness, increased fatigue, weight gain, puffy faceWBC 2500/µLInitially IV and PO levothyroxine, discharged on PO onlyWhite cell count improved after 1 week of thyroid replacement, at 3-month follow-up, her hematologic counts were stable
Hemoglobin 8.4 g/dL
Platelet 95 × 109/L