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JAMA Clinical Challenge
April 19, 2016

Pancytopenia in a Patient With Hypothyroidism

Author Affiliations
  • 1Division of Hematology and Oncology, Department of Medicine, Robert H. Lurie Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 2Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA. 2016;315(15):1648-1649. doi:10.1001/jama.2016.2155

A 25-year-old woman with history of iron-deficiency anemia and hypothyroidism presented with fatigue and weight loss for 3 weeks. She was admitted recently for hypothyroidism, with a thyroid-stimulating hormone level of 209.1 µIU/mL (reference range, 0.4-4.0 µIU/mL) and free thyroxine level of 0.4 ng/dL (reference range, 0.7-1.5 ng/dL). Complete blood cell count then revealed a leukocyte count of 3800/µL; platelet count, 158 ×103/L; hemoglobin level, 6.9 g/dL; and mean corpuscular volume, 107 μm3. She was started on levothyroxine and takes no other medications.

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