# Hashimoto's thyroiditis and acute chest syndrome revealing sickle cell anemia in a 32 years female patient

## TL;DR

A 32-year-old woman with chest pain and anemia was found to have both Hashimoto's thyroiditis and sickle cell anemia, highlighting a rare co-occurrence of these conditions.

## Contribution

This case report highlights the rare coexistence of Hashimoto's thyroiditis and sickle cell anemia in a patient without typical childhood symptoms.

## Key findings

- The patient exhibited hemolytic anemia confirmed by elevated unconjugated bilirubin and a positive Coombs test for IgG.
- Thyroid function tests revealed elevated TSH and thyroid antibodies, indicating Hashimoto's thyroiditis.
- Sickle cell anemia was diagnosed via hemoglobin electrophoresis despite the absence of childhood pain crises.

## Abstract

Sickle cell anemia results from a single amino acid substitution in the gene encoding the β-globin subunit. Polymerization of deoxygenated sickle hemoglobin leads to decreased deformability of red blood cells. Hashimoto's thyroiditis is a common thyroid disease now recognized as an auto-immune thyroid disorder, it is usually thought to be haemolytic autoimmune anemia. We report the case of a 32 years old women admitted for chest pain and haemolysis anemia in which Hashimoto's thyroiditis and sickle cell anemia were found. In our observation the patient is a young woman whose examination did not show signs of goitre but the analysis of thyroid function tests performed before an auto-immune hemolytic anemia (confirmed by a high level of unconjugated bilirubin and a Coombs test positive for IgG) has found thyroid stimulating hormone (TSH) and positive thyroid antibody at rates in excess of 4.5 times their normal value. In the same period, as the hemolytic anemia, and before the atypical chest pain and anguish they generated in the patient, the search for hemoglobinopathies was made despite the absence of a family history of haematological disease or painful attacks in childhood. Patient electrophoresis's led to research similar cases in the family. The mother was the first to be analyzed with ultimately diagnosed with sickle cell trait have previously been ignored. This case would be a form with few symptoms because the patient does not describe painful crises in childhood or adolescence.