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VOLUME 4 , ISSUE 2 ( April-June, 2018 ) > List of Articles

ORIGINAL ARTICLE

A Clinical and Etiological Study of Anemia in Patients with Primary Hypothyroidism

V Shreyas Kumar, Kotha Anusha

Keywords : Anemia, Antithyroid peroxidase antibodies, Hypothyroidism

DOI: 10.5005/jp-journals-10045-0084

License: NA

Published Online: 01-10-2018

Copyright Statement:  NA


Abstract

Introduction: Hypothyroidism has significant hematological manifestations. Overt and subclinical hypothyroidism both are associated with anemia. This study was done to evaluate the clinical and etiological profile of anemia in patients with primary hypothyroidism. Materials and methods: B ased o n t he s ymptoms a nd hormonal assay, 200 primary hypothyroidism patients were subjected to detailed examination. Patients were investigated before the thyroid hormone replacement therapy. Results: Hypothyroidism is more prevalent in women than in men. Higher percentage of hypothyroid women (54%) suffer from anemia than hypothyroid men (45%). Normocytic normochromic anemia (58.49%) was the most common type of anemia followed by microcytic hypochromic anemia (20.75%), macrocytic hypochromic anemia (12.26%), and dimorphic anemia (8.49%). Among the symptoms and signs elicited, the most common was generalized weakness seen among 49.5% of the subjects with clinical hypothyroidism, followed by weight gain (34.5%), bradycardia (27.5%), peripheral edema (23%), menstrual irregularities in females (12.5%), and cold intolerance seen in 12% of the study population. Few subjects presented with more than one sign and symptom. Majority of the subjects were investigated only after they presented with one of the signs and symptoms, hence falling under the category of clinical hypothyroidism (78%). Antithyroid peroxidase (TPO) antibodies were present in only a minor percentage (15%) of the study population, majority of them being in the 4th decade of life and incidence decreasing as age progressed probably because the mean age group of the study population was in the fourth decade of life. Women (17.41%) had a slightly higher incidence of autoimmune hypothyroidism compared with men (13.63%). Conclusion: Hypothyroidism is common in females, maximum in the third decade probably because the mean age of the study population was 32.53 years. Majority of the patients (53%) were diagnosed with anemia. Of them, majority presented with symptoms of hypothyroidism and were found to have normocytic normochromic anemia followed by microcytic hypochromic anemia. A systematic study was done to know the relationship of hypothyroidism with anemia and a study of the symptomatology of hypothyroidism. The identification of patients with hypothyroidism is an important individual and public health issue. Hence, early detection and initiation of hormone replacement therapy can minimize the incidence of associated anemia.


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  1. Fein HG, Rivlin RS. Anemia in thyroid diseases. Med Clin North Am 1975;59:1133-1145.
  2. Das C, Sahana PK, Sengupta N, Giri D, Roy M, Mukhopadhyay P. Etiology of anemia in primary hypothyroid subjects in a tertiary care center in Eastern India. Indian J Endocr Metab 2012 Dec;16(Suppl 2):S361-S363.
  3. Antonijeviæ N, Nesoviæ M, Trbojeviæ B, Miloseviæ R. Anemia in hypothyroidism. Med Pregl 1999;52(3-5):136-140 (in Croatian).
  4. Worldwide Prevalence of Anaemia 1993–2005. WHO Global Database on Anaemia.
  5. Lawrence E, Shapiro A, Surks MI. Hypothyroidism. In: Kenneth LB (ed.), Principles and practice of endocrinology and metabolism. 3rd ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2001. pp. 445-451.
  6. Cinemre H, Bilir C, Gokosmanoglu F, Bahcebasi T. Hematologic effects of levothyroxine in iron-deficient subclinical hypothyroid patients: a randomized, double-blind, controlled study. J Clin Endocrinol Metab 2009;94(1):151-156.
  7. Boelaert K, Franklyn JA. Thyroid hormone in health and disease. J Endocrinol 2005;187(1):1-15.
  8. Reginad H, Maurice FS. Hypothyroidism: clinical features and complications. Clin Endocrinol Metabol 1979;8(1):29-38.
  9. Roberts CG, Ladenson PW. Hypothyroidism. Lancet 2004 Mar 6;363(9411):793-803.
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