Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Tue, Oct 21, 2025
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Volume 16, Issue 4 (Autumn 2025)
Caspian J Intern Med 2025, 16(4): 801-806 |
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karimpour F, valizadeh M, Ranjbar H, Vosough Z. Pancytopenia in the context of Hypothyroidism and b12 deficiency: A Case Report and Review literature. Caspian J Intern Med 2025; 16 (4) :801-806
URL: http://caspjim.com/article-1-4268-en.html
URL: http://caspjim.com/article-1-4268-en.html
Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, baboll.R.Iran , F.karimpour56@yahoo.com
Abstract: (33 Views)
Background: This case of pancytopenia due to hypothyroidism and B12 deficiency is rare and severe as a reminder that, upon diagnosis of pancytopenia, endocrine disorders such as secondary thyroid hormone deficiency may need to be considered as a potential cause.
Case Presentation: A 38-year-old male presented with progressive weakness, lethargy, and anorexia. Initial labs revealed severe pancytopenia, prompting a hematological workup. Bone marrow aspiration ruled out acute leukemia. Further investigations identified severe primary hypothyroidism (TSH: 200 mIU/L) and vitamin B12 deficiency as the underlying causes, after excluding other common etiologies. Treatment with levothyroxine and vitamin B12 was initiated. The patient showed a rapid and significant hematological response, with all cell lines improving and approaching normal ranges on follow-up, confirming the diagnosis.
Conclusion: In this patient, after the diagnosis of hypothyroidism and receiving levothyroxine, we saw a better stability of the improvement of the patient’s symptoms and a further improvement in the number of any blood cell lines chiefly platelet which is one of the regulators of the coagulation pathway, and its deficiency increase the risk of bleeding.
Case Presentation: A 38-year-old male presented with progressive weakness, lethargy, and anorexia. Initial labs revealed severe pancytopenia, prompting a hematological workup. Bone marrow aspiration ruled out acute leukemia. Further investigations identified severe primary hypothyroidism (TSH: 200 mIU/L) and vitamin B12 deficiency as the underlying causes, after excluding other common etiologies. Treatment with levothyroxine and vitamin B12 was initiated. The patient showed a rapid and significant hematological response, with all cell lines improving and approaching normal ranges on follow-up, confirming the diagnosis.
Conclusion: In this patient, after the diagnosis of hypothyroidism and receiving levothyroxine, we saw a better stability of the improvement of the patient’s symptoms and a further improvement in the number of any blood cell lines chiefly platelet which is one of the regulators of the coagulation pathway, and its deficiency increase the risk of bleeding.
Policy Brief: case report |
Subject:
Hematology
Received: 2024/02/2 | Accepted: 2024/07/7 | Published: 2025/09/27
Received: 2024/02/2 | Accepted: 2024/07/7 | Published: 2025/09/27
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