A case of Addisonian pernicious anemia and Graves' disease in coexistence.

概要

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It is well recognized that the concomitant presence of autoimmune diseases and autoimmune endocrinosis can happen.The pathogenic causes of Addisonian pernicious anemia which is relatively rare in our country and Graves' disease are thought to concern with immunological mechanisms.A case of Addisonian pernicious anemia associated with Graves' disease is reported here. A 36-year-old woman was admitted to our hospital because of palpitation and dyspnea on exertion. Blood picture showed hemoglobin 3.9g/dl, MCV 111.6fl and MCH 34.8pg. Bone marrow picture was hypertrophic with megaloblasts 13.8%. Serum VB12 was 290pg/ml on the 7th day of mecobalamin 1000γ/day i. m. administration and the Schilling test was 3.44%. On the other hand, although there was no thyroid swelling, thyroid function was in the state of hyperthyroidism, which showed free T3 4.25pg/ml, free T4 2.35ng/dl and TSH 0.06uU/ml. Antibodies against gastric parietal cells, intrinsic factor, TSH receptor and microsome were found to be positive. As both thyroid and stomach develop from the embryonic foregut, it was thought that the concomitant presense of Addisonian pernicious anemia and Graves' disease was interesting from the points of embry ology and immunology.
一般社団法人国立医療学会の論文