Brian J. Bohlmann
Bohlmann BJ. Hyperthyroidism. Ann Intern Med. 1995;122:393-394. doi: 10.7326/0003-4819-122-5-199503010-00016
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Published: Ann Intern Med. 1995;122(5):393-394.
TO THE EDITOR:
A review article on hyperthyroid disease  described immune-mediated leukopenia associated with Graves disease. I describe a patient with thrombocytopenia that complicated Graves disease.
A 24-year-old pregnant Hispanic woman had Graves disease at 14 weeks gestation and was treated with propylthiouracil. Three weeks later, a routine complete blood count showed a platelet count of 20 000 cells/mm3. Examination of a bone marrow biopsy specimen showed increased megakaryocytes, and platelet-associated IgG and IgM antibodies were elevated. She was treated successfully with prednisone, 100 mg daily.
In one series , five patients with Graves disease and thrombocytopenia were described. As was the case with our patient, two patients had idiopathic thrombocytopenic purpura-like illnesses that responded to prednisone. Four of the five patients were Latin American, which raises the interesting possibility of a heritable component in Hispanic patients.
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