BMJ Case Reports 2018; doi:10.1136/bcr-2017-223887
  • Unusual presentation of more common disease/injury

Pancytopenia: a rare complication of Graves’ disease

  1. Licy L Yanes-Cardozo
  1. Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
  1. Correspondence to Dr Vishnu Vardhan Garla, vishnu.garla{at}
  • Accepted 31 January 2018
  • Published 9 March 2018


A 27-year-old male patient who presented to the emergency room with complaints of sweating, palpitations, heat intolerance, insomnia and weight loss for the last 3 months. His medical history was significant for hypertension. On examination, he was tachycardic, hypertensive, had tremors of the upper extremities and a smooth goitre with a thyroid bruit. Laboratory assessment revealed a suppressed thyroid-stimulating hormone, high free thyroxine and positive thyroid receptor antibodies. Complete blood count showed pancytopenia. As part of the work-up for pancytopenia, haptoglobin, ferritin, Coombs test, reticulocyte count hepatitis B and C antibodies were done, all of which were normal. Patient was started on methimazole, propranolol and hydrocortisone. His symptoms improved through the hospital course and he was subsequently discharged. Thyroidectomy was done once the patient’s hyperthyroidism was controlled. Levothyroxine was started for the control of postsurgical hypothyroidism. Six months after thyroidectomy, the patient was euthyroid and the pancytopenia resolved.


  • Contributors VVG and SS were involved in writing the manuscript. LY-C was involved in writing the discussion section and editing the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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