Treatment of carbimazole-induced agranulocytosis and sepsis with granulocyte colony stimulating factor.
We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with recombinant human granulocyte colony stimulating factor (G-CSF). A 72-year-old woman with a history of thyrotoxicosis presented with sore throat and fever two weeks after starting carbimazole. Investigations confirmed a leucopenia and neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.
Joseph
F
F
Department of Diabetes and Endocrinology, Arrowe Park Hospital, Wirral, Cheshire, UK.
Younis
N
N
Bowen-Jones
D
D
D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced / Q000188:drug therapy*; D013956:Antithyroid Agents / Q000009:adverse effects*; D002231:Carbimazole / Q000009:adverse effects*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D010808:Physical Examination; D011994:Recombinant Proteins; D013971:Thyrotoxicosis / Q000188:drug therapy; D016896:Treatment Outcome
D013956:Antithyroid Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D002231:Carbimazole