Retrospective analysis of 18 cases of antithyroid drug (ATD)-induced agranulocytosis.
In this study, we retrospectively analyzed 18 patients in whom antithyroid drug (ATD)-induced agranulocytosis developed during treatment of Graves' disease. All patients were more than 20 years of age, and we saw no correlation between age and the development of agranulocytosis. In 17 of 18 patients, ATD-induced agranulocytosis developed within 2 to 12 weeks of starting ATD treatment. Development of agranulocytosis was related to the dose of ATD. In some patients, agranulocytosis developed abruptly, and even weekly routine WBC and granulocyte counts failed to predict all case occurrences. Fever and sore throat were the earliest symptoms of agranulocytosis; patients who developed either of these symptoms were closely monitored immediately with WBC and granulocyte count examinations. In this series of patients, treatment with granulocyte-macrophage colony stimulating factor (GM-CSF) increased the granulocyte counts, whereas the effectiveness of glucocorticoid treatment was not confirmed.
Dai
Wei-Xin
WX
Endocrinology Department, Chinese Academy Medicine Sciences, Peking Union Medical College Hospital, Beijing, P R of China.
Zhang
Jian-De
JD
Zhan
Shi-Wei
SW
Xu
Bao-Zhen
BZ
Jin
Hong
H
Yao
Yang
Y
Xin
Wei-Chang
WC
Bai
Yao
Y
D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced* / Q000188:drug therapy; D013956:Antithyroid Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008713:Methimazole / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011441:Propylthiouracil / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies
D013956:Antithyroid Agents; D005938:Glucocorticoids; D008713:Methimazole; D011441:Propylthiouracil; D016178:Granulocyte-Macrophage Colony-Stimulating Factor