Resolution of gelatinous bone marrow transformation following hormone replacement therapy in a patient with primary insufficiency of the adrenal and thyroid glands

Intern Med. 2013;52(17):1931-6. doi: 10.2169/internalmedicine.52.0081.

Abstract

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 administration of corticosteroids and thyroid hormone replacement therapy.

Publication types

  • Case Reports

MeSH terms

  • Addison Disease / complications
  • Addison Disease / diagnosis*
  • Addison Disease / drug therapy
  • Bone Marrow Diseases / complications
  • Bone Marrow Diseases / diagnosis*
  • Bone Marrow Diseases / drug therapy
  • Hormone Replacement Therapy / methods*
  • Humans
  • Hypothyroidism / complications
  • Hypothyroidism / diagnosis*
  • Hypothyroidism / drug therapy
  • Male
  • Middle Aged