title: [Pulmonary aspergillosis due to methimazole-induced neutropenia: a case report].
abstract: A 48-year old woman with a recent diagnosis of Graves' disease arrived at the emergency room with fever, palpitations, and a sore throat. Her regular treatment included methimazole. On admission, laboratory results showed suppressed TSH, elevated free thyroxine, and neutropenia. She was admitted and started on antibiotics and granulocyte-macrophage colony stimulating factor (gm-csf). After ten days, the patient developed leukocytosis, fever, and hemoptysis. Chest CT scan showed a lung cavity with multiple nodules in the upper right lobe. Cultures from a lung biopsy were positive for Aspergillus Fumigatus and Aspergillus Flavus. Amphotericin B was started but then switched to voriconazole, with both treatments failing to result in clinical improvement. The patient died of multi-organ failure.
authors.affiliation: Servicio de Endocrinología, Hospital Nacional Cayetano Heredia, Lima, Perú. miguelpinto72@yahoo.com
authors.forename: Miguel E
authors.initials: ME
authors.lastname: Pinto
authors.forename: Claudia
authors.initials: C
authors.lastname: Banda
authors.forename: Carlos
authors.initials: C
authors.lastname: Seas
mesh_terms: D013956:Antithyroid Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008713:Methimazole / Q000009:adverse effects*; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications*; D055732:Pulmonary Aspergillosis / Q000209:etiology*
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole