Grave's disease and acquired hyposplenism.
A 38-year-old Caucasian woman was referred to the hematology clinic for unexplained leukocytosis and thrombocytosis and ‘possible myeloproliferative disorder’. Her history included only Grave's disease (GD) in remission for 2 years after methimazole treatment. A recent blood count revealed hemoglobin content to be 12.8 g/dl; white blood cells 20.7 × 103 μ/l (neutrophils 9.5 × 103; lymphocytes 8.3 × 103; monocytes 2.3 × 103; and eosinophils 0.5 × 103); and platelets 580 × 103 μ/l. The patient denied fever, night sweats, weight loss or pruritus and had no other symptoms. Examination showed a marked exophthalmos (Figure 1) with normal skin, heart rate (82 beats/min), blood pressure (130/75 mmHg) and no tremor. The thyroid was not tender but mildly and diffusely enlarged. The heart, lungs, breast …