ABOUT CONNECTION AUTOIMMUNE THYROIDITIS WITH MANIFESTATION OF IRON DEFICIENCY ANEMIA IN A CONDITION OF HYPOTHYROIDISM IN GENERAL CLINICAL PRACTICE. CLINICAL CASE

Summary: Anemia is a global public health problem that needs to be identified. When determining the algorithms for examination and treatment of anemic syndrome, it is necessary to carefully study the risk factors for its development, taking into account comorbidity. Carrying out of diagnostic search in several directions will allow to specify mechanisms of development of an anemic syndrome which at a combination worsen a clinical condition. Special attention should be paid to patients with manifestations of anemic syndrome on the background of endocrine pathology, namely autoimmune thyroiditis in hypothyroidism, as the incidence rate among women of childbearing age has increased significantly, which determines the direction of research and aim of this publication. The article presents a clinical case of observation and treatment of a patient with chronic autoimmune thyroiditis in a state of hypothyroidism and adenomyosis, accompanied by abnormal uterine bleeding, which was complicated by iron deficiency anemia. Because the patient initially considered uterine bleeding to be the main problem, she was observed by a gynecologist; at the same time changes of indicators of the general analysis of blood in favor of anemia are established. Treatment of endometriosis and the appointment of iron supplements led to improvement with the normalization of laboratory parameters. For 6 months the patient did not consult a doctor, no laboratory control was performed. If she felt worse, the patient consulted a family doctor. Careful examination with the involvement of an endocrinologist allowed to diagnose chronic autoimmune thyroiditis in a state of hypothyroidism and prescribe adequate therapy, which helped to normalize the patient's condition. Conclusion. Manifestations of anemic syndrome require determining the causes of its occurrence with the development of algorithms for examination and monitoring of treatment. The general practice physician should be the main coordinator in studying the causes of anemia and the management of patients in the outpatient phase with the involvement of physicians of other specialties.