Resolution of Gelatinous Bone Marrow Transformation Following Hormone Replacement Therapy in a Patient with Primary Insufficiency of the Adrenal and Thyroid Glands

• Published in: Internal Medicine Vol. 52; no. 17; pp. 1931 - 1936
• Main Authors: Obata, Yoshinari, Tamba, Sachiko, Yamada, Yuya, Kyo, Mitsuaki, Takahi, Yasumitsu, Saisho, Kenji, Yamato, Akiyuki, Hattori, Kenji, Ujiie, Hidetoshi, Fujita, Shigeki, Yamamoto, Koji, Matsuzawa, Yuji
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2013
• Subjects: Addison Disease - complications; Addison Disease - diagnosis; Addison Disease - drug therapy; adrenal insufficiency; Bone Marrow Diseases - complications; Bone Marrow Diseases - diagnosis; Bone Marrow Diseases - drug therapy; gelatinous bone marrow transformation; Hormone Replacement Therapy - methods; Humans; hypothyroidism; Hypothyroidism - complications; Hypothyroidism - diagnosis; Hypothyroidism - drug therapy; Male; Middle Aged
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.52.0081

A 59-year-old man with recurrent oral cancer presented with severe pancytopenia, hyponatremia and hypoglycemia. Endocrine testing showed a partial primary adrenal insufficiency and primary hypothyroidism. The bone marrow biopsy showed a gelatinous transformation with hypocellularity and fat atrophy. His pancytopenia, hyponatremia and hypoglycemia resolved following treatment with corticosteroids and thyroid hormone replacement therapy. The follow-up bone marrow biopsy demonstrated a resolution of the gelatinous transformation. This case is a rare example of a patient with a primary insufficiency of the adrenal and thyroid glands that is associated with gelatinous bone marrow transformation (GMT). The GMT was resolved through the admimistration of corticosteroids and thyroid hormone replacement therapy.