For those with any interest in Graves' disease, I think this might be worth a read. A fairly straightforward and short case report.
The following are mentioned as less often reported symptoms:
❖ pancytopenia
❖ cholestatic jaundice
❖ pulmonary hypertension
❖ labile thyroid function tests
❖ atrial fibrillation
❖ heat intolerance
❖ inability to gain weight despite a good appetite
❖ autoimmune thyroiditis
Thankfully, there was a positive end:
Post-operatively, she was initiated on levothyroxine 100 mcg OD. To date, she is euthyroid with a normal FBC and normal LFTs.
Other than opening eyes to what symptoms can occur, it raises questions about the management of changes between Carbimazole and Propylthiouracil (PTU).
Pancytopenia, Cholestatic Jaundice, and Pulmonary Hypertension: Rare Extrathyroidal Manifestations of Graves’ Disease
Introduction
Diffuse goiter, orbitopathy, pretibial myxedema (thyroid dermatopathy), and thyroid acropachy are pathognomonic features that define Grave's disease (GD); other extrathyroidal complications such as pancytopenia [1] and cholestatic jaundice [2] are rare. Only 30 cases of pancytopenia have been reported in association with GD while cholestatic jaundice is seen in only 12% of GD patients. In contrast, while GD-associated pulmonary hypertension is common (prevalence of 36-65%), patients are generally asymptomatic [3]. These three extrathyroidal manifestations have been reported in isolation and rarely together [1,4]. In this case report, we discuss a patient presenting with all three manifestations of pancytopenia, cholestatic jaundice, and pulmonary hypertension during a relapse of thyrotoxicosis.
Full paper open access here:
Graves’ disease and mental disorders
