Agranulocytosis induced by antithyroid therapy : effects of treatment with granulocyte colony stimulating factor

A 26-year-old woman was admitted to hospital with high fever, severe tonsillitis, and gastroenteritis. Because of Graves' disease she had been treated with methimazole for 18 months. Leukopenia and agranulocytosis in combination with a typical bone marrow, exhibiting a complete arrest of myelop...

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Bibliographic Details
Published in:The Clinical Investigator 1994-05, Vol.72 (5), p.390-392
Main Authors: ADORF, D, GRAJER, K. H, KABOTH, W, NERL, C
Format: Article
Language:English
Subjects:
Adult
Agranulocytosis - chemically induced
Agranulocytosis - complications
Agranulocytosis - pathology
Agranulocytosis - therapy
Biological and medical sciences
Bone Marrow - pathology
Drug toxicity and drugs side effects treatment
Female
Granulocyte Colony-Stimulating Factor - therapeutic use
Graves Disease - complications
Graves Disease - drug therapy
Humans
Immunologic Factors - therapeutic use
Infection - etiology
Leukocyte Count - drug effects
Medical sciences
Methimazole - adverse effects
Pharmacology. Drug treatments
Toxicity: blood
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Summary:A 26-year-old woman was admitted to hospital with high fever, severe tonsillitis, and gastroenteritis. Because of Graves' disease she had been treated with methimazole for 18 months. Leukopenia and agranulocytosis in combination with a typical bone marrow, exhibiting a complete arrest of myelopoiesis at the stage of promyelocytes led to the diagnosis of an antithyroid therapy induced agranulocytosis. After 1 week of antibiotic treatment without changes in neutrophil counts, granulocyte colony stimulating factor treatment at a dose of 300 micrograms/day subcutaneously was started. Twenty-four hours after the first administration the neutrophil counts began to rise, to 4389/microliters, with a maximum after the third administration and stabilizing at normal levels within 10 days. Since agranulocytosis is considered to be a severe and fatal complication of methimazole therapy, treatment with granulocyte colony stimulating factor seems to be useful for this life-threatening condition.
ISSN:0941-0198
1432-1440
DOI:10.1007/BF00252834