losartan-potassium and Graves-Disease

To report a rare case of erythrocytosis that occurred in close association with Graves' hyperthyroidism. In order to explore the role of altered erythropoiesis in hyperthyroidism, factors related to erythropoiesis were studied in 30 patients with Graves' hyperthyroidism.. The relationship between thyroid hormone level and erythrocytosis was studied in a patient with Graves' hyperthyroidism and erythrocytosis. Later, 30 consecutive patients with proven untreated Graves' hyperthyroidism and 30 age- and sex-matched healthy controls were recruited. All patients received methimazole therapy. Erythrocyte indices, thyroid function, serum erythropoietin (EPO), and hypoxia-inducible factor-1α (HIF-1α) concentrations were measured before and after eight weeks of therapy.. In our case study, erythrocytosis relapsed with elevation of thyroid hormones. Methimazole or subsequent radioiodine therapy reduced the conditions of erythrocytosis and thyroid function returned to normal. In the clinical study, erythrocyte counts, serum erythropoietin, and HIF-1α levels in the hyperthyroid group were significantly higher than those in the control subjects. All subjects were grouped together for correlation analyses and HIF-1α was shown to correlate with total triiodothyronine (TT(3)), total thyroxine (TT(4)), and EPO levels. The correlation between EPO and TT(3) or TT(4) approached significance. After eight weeks of anti-thyroid drug therapy, a small but statistically significant increase in hemoglobin and erythrocyte count with a significant decrease in HIF-1α and EPO level was seen in hyperthyroid subjects.. Erythrocytosis may appear in patients with hyperthyroidism, and one possible mechanism is thyroid hormone-induced augmentation of HIF-1α, resulting in increased EPO levels.

Topics: Adolescent; Adult; Antithyroid Agents; Erythropoietin; Female; Graves Disease; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Male; Methimazole; Middle Aged; Polycythemia; Young Adult

Graves' disease (GD) is associated with hyperthyroidism. Thyrotoxicosis adversely affects multiple organ systems including haematopoiesis. Anaemia occurring specifically in GD has not been systematically studied previously.. To define the prevalence and characteristics of the anaemia associated with GD.. Eighty-seven newly diagnosed patients with GD were recruited. Haematological indices, thyroid function and inflammatory parameters were examined at presentation and following successful treatment of hyperthyroidism.. Tertiary care academic referral centre.. Thirty-three per cent of subjects presented with anaemia. The prevalence of anaemia not attributable to other causes (GD anaemia) was 22%. GD anaemia affected 41.6% (10/24) of men compared to 17.5% of women (11/63). Mean erythropoietin (EPO) levels (15.5 +/- 5.3 mIU/ml) were within normal reference limits but significantly higher (P = 0.004) than those of the non-anaemic controls. Hgb correlated inversely with EPO (P = 0.05) and CRP (P = 0.04) levels, a relationship that persisted after multivariate adjustment for TT3 or TT4. With antithyroid therapy for 16 +/- 6.3 weeks, Hgb levels normalized in 8 out of 9 subjects with GD anaemia (10.7 +/- 0.8 to 13.5 +/- 1.3 g/dl, P = 0.0001). After normalization of Hgb, mean MCV and TIBC were significantly increased, and median ferritin and mean EPO were significantly decreased.. GD anaemia is common, resembles the anaemia of chronic disease, and is associated with markers of inflammation. It corrects promptly with return to the euthyroid state following treatment.

Topics: Adult; Anemia; Antithyroid Agents; Autoantibodies; C-Reactive Protein; Case-Control Studies; Erythrocyte Indices; Erythropoietin; Female; Ferritins; Graves Disease; Hemoglobins; Humans; Inflammation Mediators; Male; Middle Aged; Prospective Studies; Thyroid Hormones; Thyrotoxicosis; Young Adult