Page 586 - Williams Hematology ( PDFDrive )

560 Part VI: The Erythrocyte Chapter 38: Erythropoietic Effects of Endocrine Disorders 561

hormone, and prolactin, although the exact role of each of these hor- REFERENCES
mones in the pathogenesis of anemia is unknown. The resulting defi-
ciencies of thyroid hormones, adrenal hormones, and androgens are 1. Bashir H, Bhat MH, Farooq R, et al: Comparison of hematological parameters in
likely the major contributors to anemia. Combined adrenalectomy and untreated and treated subclinical hypothyroidism and primary hypothyroidism
patients. Med J Islam Repub Iran 26(4):172–178, 2012.
thyroidectomy in animals results in an anemia that is similar but not 2. Omar S, Hadj Taeib S, Kanoun F, et al: [Erythrocyte abnormalities in thyroid dysfunc-
identical to that seen after hypophysectomy. A correlation between low tion] [in French]. Tunis Med 88(11):783–788, 2010.
74
testosterone levels and anemia has been observed in human males with 3. Fein HG, Rivlin RS: Anemia in thyroid diseases. Med Clin North Am 59(5):1133–1145,
1975.
hypopituitarism resulting from nonfunctioning pituitary adenomas. 75 4. Das C, Sahana PK, Sengupta N, et al: Etiology of anemia in primary hypothyroid sub-
Red cell survival is normal in hypopituitarism, but the marrow jects in a tertiary care center in eastern India. Indian J Endocrinol Metab 16(Suppl 2):
is hypoplastic. The results of ferrokinetic studies are consistent with S361–S363, 2012.
12
decreased erythropoiesis. In addition to anemia, leukopenia and even 5. Horton L, Coburn RJ, England JM, et al: The haematology of hypothyroidism. Q J Med
45(177):101–123, 1976.
pancytopenia can occur. Replacement therapy with a combination 6. Das KC, Mukherjee M, Sarkar TK, et al: Erythropoiesis and erythropoietin in hypo-
76
of thyroid, adrenal, and gonadal hormones usually effectively corrects and hyperthyroidism. J Clin Endocrinol Metab 40(2):211–220, 1975.
anemia and other cytopenias. 76,77 Erythropoietin therapy also was effec- 7. Muldowney FP, Crooks J, Wayne EJ: The total red cell mass in thyrotoxicosis and myx-
oedema. Clin Sci (Lond) 16(2):309–314, 1957.
tive in one case of postoperative hypopituitarism refractory to hormone 8. Kakuno Y, Amino N, Kanoh M, et al: Menstrual disturbances in various thyroid dis-
replacement therapy. 78 eases. Endocr J 57(12):1017–1022, 2010.
9. Pirzio-Biroli G, Bothwell TH, Finch CA: Iron absorption. II. The absorption of
radioiron administered with a standard meal in man. J Lab Clin Med 51(1):37–48,
1958.
OTHER PITUITARY HORMONES 10. Donati RM, Fletcher JW, Warnecke MA, et al: Erythropoiesis in hypothyroidism. Proc
Soc Exp Biol Med 144(1):78–82, 1973.
Growth Hormone 11. Lerman J, Means JH: The gastric secretion in exophthalmic goitre and myxoedema. J
Growth hormone stimulates erythropoietin-induced erythropoiesis in Clin Invest 11(1):167–182, 1932.
vitro, 79,80 and children with isolated growth hormone deficiency become 12. Daughaday WH, Williams RH, Daland GA: The effect of endocrinopathies on the
blood. Blood 3(12):1342–1366, 1948.
anemic. Growth hormone replacement therapy in both children and 13. Zimmermann MB, Köhrle J: The impact of iron and selenium deficiencies on iodine
81
adults with growth hormone deficiency increases hemoglobin levels. 82–84 and thyroid metabolism: Biochemistry and relevance to public health. Thyroid
12(10):867–878, 2002.
Prolactin 14. Cinemre H, Bilir C, Gokosmanoglu F, et al: Hematologic effects of levothyroxine in
iron-deficient subclinical hypothyroid patients: A randomized, double-blind, con-
There is limited information about the influence of prolactin. Prolactin trolled study. J Clin Endocrinol Metab 94(1):151–156, 2009.
administration in mice increased the number of erythroid and mye- 15. Ravanbod M, Asadipooya K, Kalantarhormozi M, et al: Treatment of iron-deficiency
loid progenitor cells and partially corrected anemia induced by azi- anemia in patients with subclinical hypothyroidism. Am J Med 126(5):420–424,
2013.
dothymidine. Metoclopramide, which stimulates prolactin secretion, 16. Hines JD, Halsted CH, Griggs RC, et al: Megaloblastic anemia secondary to folate defi-
85
improved hemoglobin levels or reduced transfusions in three of nine ciency associated with hypothyroidism. Ann Intern Med 68(4):792–805, 1968.
patients with Diamond-Blackfan anemia. The prolactin receptor can 17. Carmel R, Spencer CA: Clinical and subclinical thyroid disorders associated with per-
86
substitute for the erythropoietin receptor in in vitro studies of erythroid nicious anemia. Observations on abnormal thyroid-stimulating hormone levels and
on a possible association of blood group O with hyperthyroidism. Arch Intern Med
differentiation. 87,88 142(8):1465–1469, 1982.
However, macroprolactinomas have not been associated with ery- 18. Green ST, Ng JP, Chan-Lam D: Insulin-dependent diabetes mellitus, myasthenia gravis,
throcytosis, but with anemia, likely the result of a concomitant decrease pernicious anaemia, autoimmune thyroiditis and autoimmune adrenalitis in a single
patient. Scott Med J 33(1):213–214, 1988.
in testosterone levels. In a retrospective review of 26 males with pro- 19. Jabbar A, Yawar A, Waseem S, et al: Vitamin B deficiency common in primary hypo-
89
12
lactinomas, a mild anemia was present in one-third, all of whom had a thyroidism. J Pak Med Assoc 58(5):258–261, 2008.
macroprolactinoma. Hemoglobin levels did not correlate with serum 20. Cline MJ, Berlin NI: Erythropoiesis and red cell survival in the hypothyroid dog. Am J
90
Physiol 204:415–418, 1963.
prolactin levels, but did correlate with the presence of hypogonadism. 90 21. Kiely JM, Purnell DC, Owen CA: Erythrokinetics in myxedema. Ann Intern Med
67(3):533–538, 1967.
Gonadotropins 22. Shalet M, Coe D, Reissmann KR: Mechanism of erythropoietic action of thyroid hor-
Pituitary adenomas that secrete gonadotropins are rare, but have been mone. Proc Soc Exp Biol Med 123(2):443–446, 1966.
associated with erythrocytosis, likely due to testosterone excess. 91 23. Gordon AS, Kadow PC: The thyroid and blood regeneration in the rat. Am J Med Sci
212(4):385–394, 1946.
24. Golde DW, Bersch N, Chopra IJ, et al: Thyroid hormones stimulate erythropoiesis in
vitro. Br J Haematol 37(2):173–177, 1977.
HYPERPARATHYROIDISM 25. Fandrey J, Pagel H, Frede S, et al: Thyroid hormones enhance hypoxia-induced erythro-
poietin production in vitro. Exp Hematol 22(3):272–277, 1994.
26. Perrin MC, Blanchet JP, Mouchiroud G: Modulation of human and mouse erythropoie-
Anemia not attributable to other causes is present in 3 to 5 percent of sis by thyroid hormone and retinoic acid: Evidence for specific effects at different steps
patients with primary hyperparathyroidism; these patients usually have of the erythroid pathway. Hematol Cell Ther 39(1):19–26, 1997.
severe hyperparathyroidism. 92,93 The anemia is normochromic and 27. Ng YY, Lin HD, Wu SC, et al: Impact of thyroid dysfunction on erythropoietin dosage
in hemodialysis patients. Thyroid 23(5):552–561, 2013.
normocytic and resolves or improves after parathyroidectomy. 92,93 The 28. Song SH, McCallum CJ, Campbell IW: Hypoplastic anaemia complicating myxoedema
cause of the anemia is unknown; marrow fibrosis is present in some coma. Scott Med J 43(5):149–150, 1998.
but not all patients. 92,94 Although there is no correlation with marrow 29. Sullivan PS, McDonald TP: Thyroxine suppresses thrombocytopoiesis and stimulates
erythropoiesis in mice. Proc Soc Exp Biol Med 201(3):271–277, 1992.
fibrosis and the duration of hyperparathyroidism, the presence of mar- 30. Nightingale S, Vitek PJ, Himsworth RL: The haematology of hyperthyroidism. Q J Med
row fibrosis may positively correlate with improvement in anemia after 47(185):35–47, 1978.
parathyroidectomy. 94 31. Perlman JA, Sternthal PM: Effect of 131i on the anemia of hyperthyroidism. J Chronic
Dis 36(5):405–412, 1983.
Although anemia in patients with renal failure is multifactorial, 32. Gianoukakis AG, Leigh MJ, Richards P, et al: Characterization of the anaemia associ-
secondary hyperparathyroidism may contribute to refractoriness to ated with Graves’ disease. Clin Endocrinol (Oxf) 70(5):781–787, 2009.
erythropoietin therapy. Parathyroidectomy or medical treatment of 33. McClellan JE, Donegan C, Thorup OA, et al: Survival time of the erythrocyte in
myxedema and hyperthyroidism. J Lab Clin Med 51(1):91–96, 1958.
hyperparathyroidism may improve anemia and decrease requirements 34. Donati RM, Warnecke MA, Gallagher NI: Ferrokinetics in hyperthyroidism. Ann
for exogenous erythropoietin therapy. 95–98 Intern Med 63(6):945–950, 1965.

Kaushansky_chapter 38_p0559-0562.indd 561 9/17/15 6:19 PM