title: [Hyperthyroid and acute tonsillitis in a 23-year-old woman].
abstract: A 23-year-old woman with preexisting Graves' disease who received thiamazole treatment presented with fever, dysphagia, hyperthyroidism and leukopenia. With suspicion of thyreotoxicosis accompanied by drug-induced agranulocytosis she was successfully managed by plasmapheresis, G‑CSF administration and inhibition of periphereal conversion of thyroid hormones. In due course she underwent thyroidectomy. Thiamazole is frequently associated with drug-induced agranulocytosis. Long-term therapy with thiamazole requires critical evaluation and alternatives should be considered early. Plasmapheresis is an adequate treatment option to achieve normal thyroid hormonal status.
authors.affiliation: Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland. georg.beyer@uni-greifswald.de.
authors.forename: G
authors.initials: G
authors.lastname: Beyer
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland.
authors.forename: I
authors.initials: I
authors.lastname: Küster
authors.affiliation: Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Budde
authors.affiliation: Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
authors.forename: E
authors.initials: E
authors.lastname: Wilhelm
authors.affiliation: Klinik und Poliklinik für Allgemeine Chirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Hoene
authors.affiliation: Institut für Pathologie, Universitätsmedizin Greifswald, Greifswald, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Evert
authors.affiliation: Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Stracke
authors.affiliation: Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Friesecke
authors.affiliation: Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Mayerle
authors.affiliation: Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Steveling
mesh_terms: D000208:Acute Disease; D000328:Adult; D013956:Antithyroid Agents / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D008713:Methimazole / Q000009:adverse effects*; D010956:Plasmapheresis / Q000379:methods*; D014069:Tonsillitis / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents; D016179:Granulocyte Colony-Stimulating Factor; D008713:Methimazole
keywords: Agranulocytosis; Graves’ disease; Plasmapheresis; Thiamazole, adverse effects; Thyrotoxicosis