Agranulocytosis associated with anti-thyroid drug in patients with Graves' thyrotoxicosis--report of 11 cases.
Retrospective analysis of 11 Chinese patients with Graves' thyrotoxicosis developing agranulocytosis during anti-thyroid treatment was done. Seven of them received methimazole and 4 received carbimazole. None of the 11 patients had taken propylthiouracil. The major chief complaints were high fever (100%), chillness (91%), and sore throat (73%). The duration of drug treatment prior to the detection of agranulocytosis ranged from 13 to 63 days (mean +/- 1SE: 33.1 +/- 16.1). At the time of agranulocytosis detected, the peripheral leukocyte counts were 0.5 to 2.1 X 1000/mm3 (mean +/- 1SE: 1.05 +/- 0.47 X 1000/mm3), absolute neutrophil counts 0 to 450/mm3 (mean +/- 1SE: 54.27 +/- 132.12/mm3), and hemoglobin 8.2 to 15.9 g/dl (mean +/- 1SE: 11.85 +/- 2.24 gm/dl). Three of the 11 patients had positive bacterial blood cultures. The recovery time of absolute neutrophil counts above 500/mm3 ranged from 3 to 25 days (mean +/- 1SE: 10.5 +/- 6.6) after discontinuation of antithyroid drugs. Mortality was found in 2 of them (18%).
Li
K L
KL
Department of Metabolism, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Huang
H S
HS
Wang
P W
PW
Lin
J D
JD
Juang
J H
JH
Liu
R T
RT
Huang
B Y
BY
Huang
M J
MJ
D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced*; D013956:Antithyroid Agents / Q000009:adverse effects*; D002231:Carbimazole / Q000009:adverse effects; D005260:Female; D006111:Graves Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008713:Methimazole / Q000009:adverse effects; D008875:Middle Aged; D013971:Thyrotoxicosis / Q000188:drug therapy*
D013956:Antithyroid Agents; D008713:Methimazole; D002231:Carbimazole