Reactions 1704, p359 - 2 Jun 2018 Agranulocytosis: case report A 61-year-old woman developed agranulocytosis during treatment with thiamazole for hyperthyroidism [route and dosage not stated]. The woman admitted to the emergency department with the complaints of fever, chills, cough and general weaknesses. These symptoms were started a day after her discharge from a hospital. During her previous hospitalisation, she received treatment for gastric pain and neutropenia, induced by thiamazole. She had a history of hyperthyroidism for 21 years, and 6 months prior to the previous hospitalisation, she started receiving thiamazole. At the time of admission to current hospital (current presentation), she was febrile with a temperature of 38.8 °C and her RR was 22 /min. Physical examination showed atonic bilateral equal air entry. Her chest X-ray revealed a multifocal abscessing pneumonia. A CT confirmed multifocal abscesses in lungs. Her lab investigation showed a haemoglobin of 12.5 gm/dL, WBC count of 9 9 8.8 × 10 /L, neutrophil 5.59×10 /L and platelets count of 197×10 /L. Arterial blood gas analysis showed a pH of 7.30 and PaO2 of 60mm Hg, PCO2 of 46mm Hg and SaO2 of 90% [duration of treatment to reaction onset not clearly stated]. Initially, the woman received empirical treatment with vancomycin, amikacin and other broad-spectrum antibiotics. Her culture investigation did not yield any aetiology. Thereafter, meropenem was added in her treatment, this led to a gradual improvement. After 14 days treatment, she was discharged in a good condition. Author comment: "The antithyroid agents (carbimazole, methimazole, thiamazole, propylthiouracil and benzylthiouracile) are the drug class that is associated with a high risk of agranulocytosis." "Antithyroid drugs, especially thioamides-including propylthiouracil, methimazole and carbimazole have adverse hematological effects, ranging from mild leukopenia to agranulocytosis andaplastic anemia." Lazovic B, et al. Thiamazole-Induced Agranulocytosis Leading to Abscessus Pneumonia-Rare, But Challenging. Archivos de Bronconeumologia 54: 289-290, No. 5, May 2018. Available from: URL: http://doi.org/10.1016/ j.arbres.2017.10.005 - Serbia 803323723 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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