バセドウ病の再燃・寛解に伴い心不全・貧血・血小板減少を繰り返した一例

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A 78-years old woman was diagnosed with Basedow's disease and the disease had been poorly controlled because of side effects of anti-thyroid drugs. In the out patient clinic, she was suffered from right pleural effusion, thrombocytopenia and anemia. She was admitted for treatment of these symptoms. On admission, blood examination revealed manifest hyperthyroidism and she was given iodine and a little MMI. Immediately thyroid function was normalized and then pleural effusion, thrombocytepenia and anemia improved without any other therapy. Then we prepared for ^<131>I therapy and stopped giving iodine and MMI. Then pleural effusion, thrombocytopenia and anemia returned. Afterwards ^<131>I therapy, she was administered with iodine and MMI again. Thyroid function improved to the euthyroid level and pleural effusion, thrombocytopenia and anemia improved again. Ever since thyroid function has been retained to the level euthyroid and complications has not reappeared. In the hyperthyroid state, We sometimes experience complication of congestive heart failure. But little has been reported concerning the improvement of heart failure by only normalizing thyroid function. Anemia has sometimes been recognized as a complication of hyperthyroidism. But the mechanism of anemia concerning hyperthyroidism is unknown. Many report have been shown thrombocytopenia with hyperthyroidism in 20∿30 year old women. But like in our patient, thrombocytopenia can occur in elderly hyperthyroid patients. So we must take care to examine these phenomena in the daily clinics.
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バセドウ病の再燃・寛解に伴い心不全・貧血・血小板減少を繰り返した一例

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