Ann Pediatr Endocrinol Metab.  2012 Jun;17(2):122-125. 10.6065/apem.2012.17.2.122.

The Treatment of Pernicious Anemia in Children with Graves' Disease

Affiliations
  • 1Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea. pedsjs@hallym.or.kr

Abstract

Organ specific autoimmune diseases may occur in the same individual. Type III polyglandular autoimmune disease is defined by the occurrence in the same individual of two or more of the following: autoimmune thyroid disease, pernicious anemia, insulin dependent diabetes, and other organ specific autoimmune diseases not falling into class I or class II categories. A 16-year-old girl developed pernicious anemia during the treatment of Graves' disease. She was diagnosed with Graves' disease 5 years ago and had received methimazole 20 mg/day, but the medication was not well tolerated. Bone marrow findings were compatible with pernicious anemia as macrocytic normochromic red blood cell (RBC) and increased megakaryocyte. The serum value of vitamin B12 was low, and the serum titer of antibody to gastric parietal cell was high. After diagnosis of pernicious anemia, she had treatment by monthly intramuscular vitamin B12 and methimazole (20 mg/day). The values of hemoglobin and RBC indices as well as thyroid function were normalized after 2 months. Vitamin B12 therapy was maintained for 1 year with normal RBC indices. At present, she dose not receive treatment with vitamin B12 but she does receive methimazole treatment. We report a case of treatment of pernicious anemia in a 16 year-old girl during treatment for Graves disease.

Keyword

Graves disease; Anemia, pernicious

MeSH Terms

Adolescent
Anemia, Pernicious
Autoimmune Diseases
Bone Marrow
Child
Erythrocytes
Graves Disease
Hemoglobins
Humans
Insulin
Megakaryocytes
Methimazole
Parietal Cells, Gastric
Thyroid Diseases
Thyroid Gland
Vitamin B 12
Hemoglobins
Insulin
Methimazole
Vitamin B 12
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