Objective To look into the clinical features as well as treatment approaches and effects of Graves disease complicated with leukopenia.Methods A total of 36 cases of Graves disease complicated with leukopenia diagnosis and treated by our facility were reviewed.Causes of leucopenia, correlations between serum TRAb levels and numbers of leukocytes, and effects of anti - leukopenia therapies were summarized.Results Leukopenia developed after antithyroid treatment ( thiamazole: 61.9％ ; propylthiouracil: 38.1％ ) in 21 ( 58.3％ ) cases, and were caused by in the other 15 ( 41.7％ ) of the patients.Leukopenia caused by hyperthyroidism were negatively correlated with Serum TRAb levels ( P ＜ 0.01 ), whereas leucopenia caused by antithyroid drugs showed no correlation with TRAb levels.A medication of leucogen combined with either propylthio-uracil or prednisone was applied to the hyperthyroidism cases, while leukopenia caused by anti-thyroid drugs received treatment of leucogen and/or in combination with prednisone, with withdraw of ATD Leukocyte numbers in all cases became normal after treatment.Conclusion Leukopenia in patients with Graves disease may develop from either the intrinsic hyperthyroidism or the side-effects of anti - thyroid drugs.Accordingly, different approaches of treatment should be applied to normalize enumeration of leukocyte.%目的 分析Graves病合并白细胞减少患者的临床特点、治疗方法及效果.方法 回顾性分析我科确诊的36例Graves病合并白细胞减少患者的病历资料,探讨白细胞减少的原因及血清促甲状腺激素受体(TRAb)水平与白细胞计数间的关联,总结白细胞减少的治疗方法.结果 36例患者中21例(58.3%)发生于抗甲状腺药物(ATD)治疗后,以甲巯咪唑治疗后多见(61.9%),其次是丙基硫氧嘧啶(38.1%)治疗;15例(41.7%)由Graves病甲亢本身引起.甲亢本身所致的白细胞减少与血清TRAb水平呈负相关(P＜0.01),而药物引起的白细胞减少与TRAb无关.针对甲亢本身引起的白细胞减少,给予丙基硫氧嘧啶或强的松联合利血生治疗;针对ATD引起的白细胞减少,视病情停用ATD,予以利血生或联合强的松治疗.治疗后患者白细胞计数均可恢复正常.结论 Graves病并发白细胞减少可由甲亢本身引起,也可由ATD引起.针对病因,给予不同的治疗方案后可使白细胞计数恢复正常.
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