[Dr.Vad]

и еще кое-что из недавней инолит. по теме без перевода:
из Spivak JL. The blood in systemic disorders.
Lancet. 2000 May 13;355(9216):1707-12.

Endocrine disease

Erythropoietin is the only hormone obligatory for erythropoiesis but this process is normally influenced directly or indirectly by many other hormones. In general, the haematological abnormalities associated with endocrine-gland insufficiency reflect the function of the involved gland. In most cases, the development of the endocrine abnormality is so insidious and the anaemia so bland that in this situation the best haematologist is a good internal medicine specialist.

Pituitary––The anaemia associated with anterior pituitary failure is normocytic and normochromic, mild in degree, and puzzling unless the relation between tissue oxygen consumption and red-cell production is considered. With Sheehan's syndrome, the onset of the endocrine failure may be remote from the causal event, and pancytopenia or a coagulation abnormality may be the presenting feature.[21]

Gonads––Androgen insufficiency results in a 1–2 g/dL (10–20 g/L) decrease in the haemoglobin concentration and macrocytosis, but the other symptoms of gonadal insufficiency are more obvious. As a corollary, androgen excess, commonly the result of self-medication, causes erythrocytosis. Abnormalities of the oestrogen-progesterone axis are not associated with anaemia, although oral contraceptives can interfere with metabolism of folic acid and have rarely been implicated in acquired sideroblastic anaemia.

Adrenal––The anaemia associated with chronic adrenal insufficiency is partly masked by a concomitant reduction in plasma volume. Lymphocytosis, neutropenia, and eosinophilia are important clues to the cause of the anaemia in this setting. Chronic adrenal insufficiency may also be complicated by pernicious anaemia.

Parathyroid––Although uncommon in primary hyperparathyroidism, anaemia in this disorder has the classic characteristics of the anaemia of chronic disease but is usually the consequence of the myelosclerosis associated with advanced disease. Blood abnormalities in the setting of hypoparathyroidism may be due to pernicious anaemia or even red-cell aplasia, usually in the setting of a type I polyendocrinopathy syndrome.

Thyroid––Haematological abnormalities are associated with both hypothyroidism and hyperthyroidism but in a reciprocal relation.[22 and 23] With hypothyroidism, anaemia may be masked by a decrease in plasma volume, and a relative macrocytosis is common even in the absence of anaemia or deficiency of folic acid or vitamin B12. With thyroid replacement, the mean corpuscular volume (MCV) falls. If microcytosis occurs, it is usually in the setting of menorrhagia, which in some cases is associated with acquired type 1 von Willebrand's disease. [24] Acanthocytosis, although not severe in most cases, is another haematological feature of hypothyroidism. In hyperthyroidism, microcytosis is common even in the absence of anaemia, and an increase in the plasma volume can mask a slight increase in red-cell mass. In some patients, hypothyroid or hyperthyroid, iron distribution abnormalities typical of the anaemia of chronic disease have been documented. Hypothyroidism commonly occurs in the setting of pernicious anaemia whereas hyperthyroidism typically predates this type of anaemia. [25] Leucopenia and immune thrombocytopenia can occur with hyperthyroidism, as can generalised lymphadenopathy and lymphocytosis. Hyperthyroid patients are also at risk of agranulocytosis with propylthiouracil or thiamazole therapy.

21. C.H. Brown, L.K. Kvols and T.H. Hsu, Factor IX deficiency and bleeding in a patient with Sheehan's syndrome. Blood 39 (1972), pp. 650–657.
22. L. Horton, R.J. Coburn and J.M. England, The haematology of hypothyroidism. QJM 177 (1975), pp. 101–124.
23. S. Nightingale, P.J. Vitek and R.L. Himsworth, The haematology of hyperthyroidism. QJM 185 (1978), pp. 35–47.
24. R.G. Dalton, G.F. Savidge and K.B. Matthews, Hypothyroidism as a cause of aquired von Willebrand's disease. Lancet (1987), pp. 1007–1009.
25. R. Carmel and C.A. Spencer, Clinical and subclinical thyroid disorders associated with pernicious anemia. Arch Intern Med 142 (1982), pp. 1465–1469.