A Case of Pernicious Anemia Associated with Autoimmune Thyroid Disease / 대한혈액학회지

ABSTRACT

Pernicious anemia is understood as an autoimmune disease and associated with various other autoimmune diseases, such as Graves` disease, primary hypothyroidism, thyroiditis and vitiligo. We report a case of pernicious anemia associated with autoimmune thyroiditis. A 40-year-old man was admitted to the Sanggye Paik Hospital due to general weakness, dyspnea on exertion and sore throat for 2 months. Eight years before admission, he had been treated with hyperthyroidism in other hospital. Examination revealed anemic conjunctivae, exophthalmos and smooth and beefy tongue. Laboratory tests showed 6.2g/dL of hemoglobin, 16.7% of hematocrit, 7,970/microliter of WBC, 152,000/microliter of platelets and 116.3fL of MCV. Reticulocyte index was 0.3%. Peripheral blood smear showed macrocytic red blood cells and hypersegmented neutrophils. The level of vitamin B12 was 139.2pg/mL and folic acid was in normal range. The result of schilling test was abnormal. Anti-parietal cell antibody was positive. The results of thyroid function tests were compatible with hypothyroidism and anti-microsomal antibody was positive. TBII was 9.8U/L. Treatment with vitamin B12 and thyroid hormone was started. Three months after treatment, he has been completely free of symptoms. Now he has been treated with thyroxine 0.2mg per day and adenosylcobalamine 1,000microgram per 2 month.