title: Graves' disease in a 3 year-old patient with agranulocytosis due to anti-thyroid drugs: Radioiodine ablation therapy as an effective alternative.
abstract: The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with131I ablation therapy. The relevance of the article is that Graves' disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with131I at this age, makes this case unique.
authors.affiliation: Unidad de Gestión Clínica de Medicina Nuclear, Hospital Regional Universitario de Málaga, Málaga, España. Electronic address: elenaespinosamunoz@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Espinosa-Muñoz
authors.affiliation: Unidad de Gestión Clínica de Medicina Nuclear, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: D
authors.initials: D
authors.lastname: Ramírez-Ocaña
authors.affiliation: Unidad de Gestión Clínica de Medicina Nuclear, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Martín-García
authors.affiliation: Unidad de Gestión Clínica de Medicina Nuclear, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Ruiz-García
authors.affiliation: Unidad de Gestión Clínica de Medicina Nuclear, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: C
authors.initials: C
authors.lastname: Puentes-Zarzuela
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced* / Q000628:therapy; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001803:Blood Transfusion; D002231:Carbimazole / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications; D004359:Drug Therapy, Combination; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D007888:Leigh Disease / Q000150:complications; D009404:Nephrotic Syndrome / Q000150:complications; D011433:Propranolol / Q000627:therapeutic use; D012598:Sclerosis / Q000150:complications
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D002231:Carbimazole; D011433:Propranolol
keywords: (131)I; Agranulocitosis; Agranulocytosis; Anti-thyroid drugs; Enfermedad de Graves; Fármacos antitiroideos; Graves’ disease