Endocrine Abstracts

Introduction: Leukopenia is a manifestation of autoimmune diseases such as systemic lupus erythematosus (SLE). Leukopenia may be an early sign of autoimmunity and may be a comorbidity in patients with autoimmune Hashimoto’s thyroiditis.

Aim: The aim was to present a cohort of 12 patients with autoimmune Hashimoto’s thyroiditis who presented with leukopenia.

Methods: A cohort of 12 patients, aged 19-72 y, female, with autoimmune Hashimoto’s thyroiditis is described. Patients presented with leukopenia. Leukopenia was defined as a white blood cell count <4000 cells/mm³.

Results: The white blood cell count remained <4000cells/mm³ in a period of follow-up of 5-15 years. The white blood cell count varied in long-term follow-up. A female patient aged at diagnosis of Hashimoto’s thyroiditis 42 y, developed breast cancer in her left and consequently her right breast at the age of 63 and had to receive chemotherapy. The white blood cell count deteriorated further during chemotherapy, but she was able to finish the therapeutic regimen. In long-term follow up her white blood cell count improved but remained <4000cells/mm³.

Conclusions: Disorders of white blood cells may accompany autoimmunity. Neutropenia has been described in the context of autoimmune thyroid disease. Idiopathic neutropenia has been described as a benign disorder of granulopoiesis characterized by unexplained reduction in the absolute neutrophil count below the lower limit of the normal for a prolonged period. It has been divided in primary autoimmune neutropenia characterized by autoantibodies against mature neutrophils and their bone marrow progenitors and chronic immunologic neutropenia characterized by suppression of granulopoiesis. Both disease entities usually display an uncomplicated clinical course with minimal symptoms. Leukopenia and lymphopenia have been described in the context of SLE. Leukopenia characterized by a benign clinical course may be an early sign of autoimmunity and may accompany autoimmune Hashimoto’s thyroiditis. In conclusion, leukopenia may be a manifestation of Hashimoto’s thyroiditis, especially in female patients and it is characterized by a benign clinical course.