하시모토 갑상선중독증 및 휘트르레 선종과 동반된 본태성 혈소판증가증

저자들은 심계항진과 전경부 종괴를 주소로 내원하여 시행 받은 갑상선기능검사, 갑상선 자가항체검사, 병리조직학적 검사 및 골수조직검사에서 하시모토 갑상선중독증 및 휘트르레 선종과 동반된 본태성 혈소판증가증으로 진단된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Hashitoxicosis, a rare cause of primary hyperthyroidism, is diagnosed by presence of thyrotropin receptor antibody, increased radioiodine uptake and histological finding of lymphoid follicle with lymphcytic infiltration. Thrombocytopenia associated with hyperthyroidism including hashitoxicosis is probably caused by increased destruction of platelets in reticuloendothelial phagocytic system although it is partially compensated by increased production of magakaryocytes in bone marrow. Because essential thrombocythemia in hyperthyroid state has not been reported, most cases of thrombocytosis developed in the treatment of hyperthyroidism are considered as secondary thrombocytosis without any further examination. We experienced fourty-seven year-old woman presenting with palpitation and anterior neck swelling. By endocrinological and histological examinations, she was diagnosed as hashitoxicosis and Hurthle cell adenoma. For evaluation of progressive thrombocytosis, bone marrow biopsy was performed, in which essential thrombocythemia was diagnosed. In summary, we report the first case of an essential thrombocythemia with hashitoxicosis and Hurthle cell adenoma. (Korean J Med 69:S856-S860, 2005)