Managing a Case of Severe Graves Disease with Idiopathic Aplastic Anemia

Background/Objective Both aplastic anemia and Graves disease are often autoimmune in nature. The coexistence of aplastic anemia and Graves disease is rare but poses a significant challenge for management due to the hematologic risks associated with thionamides. Case Presentation We report the case of an 18-year-old female with a history of idiopathic aplastic anemia who developed severe Graves disease. The primary clinical challenge was to establish a prompt control of the hyperthyroidism and bridge to a safer definitive management with total thyroidectomy while minimizing the patient's exposure to thionamides. After multidisciplinary discussion, she was medically optimized to an euthyroid state with iodine therapy followed by a thyroidectomy. Discussion This case highlights an individualized, multidisciplinary management strategy for Graves disease in the setting of aplastic anemia, where standard antithyroid therapy may carry substantial risk. Conclusion Clinicians should recognize the unique management considerations in patients with concurrent Graves disease and aplastic anemia and consider individualized approaches to definitive therapy.