Methimazole-induced aplastic anemia in third exposure: successful treatment with recombinant human granulocyte colony-stimulating factor.
The major adverse reactions of antithyroid drugs are hematologic; aplastic anemia (AA) is one of the rarest and most severe complications. Use of recombinant human hemopoietic colony-stimulating factor was reported to be of benefit in patients who developed agranulocytosis, although there is still some doubt regarding the efficacy in AA. We present a case of a 58-year-old female patient with Graves' disease who developed AA in the third exposure to methimazole (MMI). The withdrawal of MMI and early treatment with 5 microg/kg per day recombinant human granulocyte colony-stimulating factor (G-CSF) for 9 days, allowed a favorable recovery of peripheral blood cell count. We conclude that the use of hemopoietic colony stimulating factors might be a suitable means to achieve the correction of severe thionamide-induced hematologic adverse reactions.
Endocrine Unit, University Hospital of Granada, Spain.
P
P
Mezquita
V
V
Luna
M
M
Muñoz-Torres
E
E
Torres-Vela
F
F
Lopez-Rodriguez
J L
JL
Callejas
F
F
Escobar-Jimenez
D000741:Anemia, Aplastic / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D001773:Blood Cells / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D008713:Methimazole / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D008713:Methimazole