Jin-Yin W1, Yuan L2 and Yang Yang1,3*
1Department of Endocrinology, Tianyou Hospital Affiliated to Wuhan University of Technology, China 2Department of Clinical Laboratory, Chengdu Fifth People's Hospital, China 3Department of Medicine, Wuhan University of Technology, ChinaFulltext PDF
This report described a case of primary myelofibrosis patient, who has a medical history of 20 years type 2 diabetes mellitus and 4-year Hashimoto's thyroiditis. The patient was admitted to our hospital due to lower limbs edema, and then developed dyspnea while walking. Physical examination revealed exuberant peripheral edema and jugular venous distention. Magnetic resonance imaging scan showed enlarged spleen. Blood tests showed an elevated white blood cells, LDH, and natriuretic peptide. Bone marrow biopsy reveled megakaryocytic hyperplasia and atypia, fibroblast proliferation and increased bone trabecula. Gene tests detected JAK2V617F mutation, without the BCR-ABL. These clinical and laboratory evidences support the diagnosis of Primary Myelofibrosis. Following 2 months treatment of hydroxyurea, danazol, thalidomide, and ruxolitinib, the clinical symptoms and physical signs were improved, but anemia progressed and suggested high risk patient. Chronic inflammation, insulin resistance, hyperinsulinemia, and insulin treatments of type 2 diabetes mellitus, and potentially Hashimoto's thyroiditis, may be associated with developmental primary myelofibrosis.
Jin-Yin W, Yuan L, Yang Yang. Type 2 Diabetes Mellitus with Primary Myelofibrosis and Hashimoto's Thyroiditis: A Case Report. Ann Clin Case Rep. 2021; 6: 1934.