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<p>Graves’ disease, an autoimmune thyroid disorder, rarely presents with pancytopenia. The proposed mechanisms include immune-mediated peripheral destruction, nutritional deficiencies, and impaired bone marrow hematopoiesis. We report three cases of newly diagnosed Graves’ disease presenting with pancytopenia, generalized weakness, weight loss, and diffuse thyroid enlargement. All patients had biochemical thyrotoxicosis with positive thyroid receptor antibodies, and bone marrow evaluation demonstrated normocellular to hypercellular marrow, with one case associated with autoimmune vitamin B12 deficiency. A review of the literature identified 32 previously reported cases of pancytopenia associated with Graves’ disease. Management with antithyroid drugs (methimazole or carbimazole), beta-blockers, and supportive therapy resulted in rapid hematological recovery and clinical improvement in all cases. This case series underscores pancytopenia as a rare diagnosis of exclusion in Graves’ disease and highlights the reversibility of hematological abnormalities following timely achievement of euthyroidism with thionamide therapy.</p>

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Pancytopenia Associated with Newly Diagnosed Graves’ Disease: A Case Series and Review of Literature

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Naman Lodha,
  • Durga Shankar Meena,
  • Pyrus Bhellum,
  • Manika Malik,
  • Saloni Darshan Talreja,
  • Aayush Dukiya,
  • Satyendra Khichar

摘要

Graves’ disease, an autoimmune thyroid disorder, rarely presents with pancytopenia. The proposed mechanisms include immune-mediated peripheral destruction, nutritional deficiencies, and impaired bone marrow hematopoiesis. We report three cases of newly diagnosed Graves’ disease presenting with pancytopenia, generalized weakness, weight loss, and diffuse thyroid enlargement. All patients had biochemical thyrotoxicosis with positive thyroid receptor antibodies, and bone marrow evaluation demonstrated normocellular to hypercellular marrow, with one case associated with autoimmune vitamin B12 deficiency. A review of the literature identified 32 previously reported cases of pancytopenia associated with Graves’ disease. Management with antithyroid drugs (methimazole or carbimazole), beta-blockers, and supportive therapy resulted in rapid hematological recovery and clinical improvement in all cases. This case series underscores pancytopenia as a rare diagnosis of exclusion in Graves’ disease and highlights the reversibility of hematological abnormalities following timely achievement of euthyroidism with thionamide therapy.