Severe neutropenia induced by propylthiuracil
DOI:
https://doi.org/10.51481/amc.v60i1.992Keywords:
Graves disease, antithyroid drugs, propylthiuracil, hyperthyroidism, agranulocytosisAbstract
Patients with hyperthyroidism have several treatment options. The treatment of Graves' disease consists of blocking the excess of thyroid hormones using thionamides, thyroidectomy or I131 therapy. Antithyroid agents such as methimazole, carbimazole, propylthiuracil are effective in controlling hyperthyroidism in patients with Graves' disease, but they have adverse effects including, allergies, gastritis, hepatitis and agranulocytosis. We present a hyperthyroid patient with severe neutropenia during treatment with propylthiuracil.
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References
Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. American thyroid association guidelines for diagnosis and manangement of hyperthyroidism and other causes of thyrotoxicosis. Thyroid 2016; 26:13431421.
Ross DS. Radioiodine therapy for hyperthyroidism. N Engl J Med 2011; 364:542-550.
Tagami T, Yambe Y, Tanaka T, Tanaka T, Ogo A, Yoshizumi H, et al. Shortterm effects of β-adrenergic antagonists and methimazole in new-onset thyrotoxicosis caused by Graves´disease. Intern Med 2012;51:2285-2290.
Johnston A, Uetrecht J. Current understanding of the mechanism of idiosyncratic drug-induced agranulocytosis. Expert Opin Drug Metab Toxicol 2015;11:243-257.
Tamai H, Sudo T, Kimura A, Mukuta T, Matsubayashi S, Kuma k, et al. Association between the DRB1*08032 histocompatibility antigen and methimazoel-induced agranulocytosis in Japanese patients with Graves´ disease. Ann Intern Med 1996;124:490-499.
Tamai H, Takaichi Y, Morita T, Komaki G, Matsubayashi S, Kuma k, et al. Methimazole-induced agranulocytosis in Japanese patients with Graves' disease. Clin Endocrinolog (Oxf) 1989; 30:525-530.
Cooper DS, Goldminz D, Levin AA, Ladenson PW, Daniels GH, Molitch ME, et al. Agranulocytosis associated with antithyroid drugs. Effects of patients age and drug dose. Ann Intern Med 1983;98:26-29.
Takata K, Kubota S, Fukata S, Kudo T, Nishihara E, Ito M, et al. Methimazoleinduced agranulocytosis in patients with Graves' disease is more likely with a daily dose of 30 mg than with 15 mg. Thyroid 2009;19:559-563.
Sheng WH, Hung CC, Chen C, Fang CT, Hsieh SM, Chang SC, et al. Antithyroid drug-induced agranulocytosis complicated by life-threatennig infections. Q J Med 1999; 92:455-461.
Tajiri J, Noguchi S, Murakami T, Murakami N. Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring. Arch Intern Med 1990;150:621-624.
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