Development of Agranulocytosis after Discontinuation of Methimazole: An Unusual Case

Case Reports in Endocrinology
Rıfkı ÜçlerYusuf Demir

Abstract

Agranulocytosis is a rare and critical adverse effect of antithyroid drugs (ATD). The occurrence of agranulocytosis in continuous ATD treatment patients is well known; however, a case of ATD agranulocytosis occurring following the discontinuation of methimazole (MMI) treatment is not a usual situation. We herein describe a case of a 41-year-old woman who was previously administered methimazole (MMI) for ten days and developed ATD-induced agranulocytosis and symptoms of an upper respiratory tract infection after three weeks following discontinuation of MMI treatment. A thorough hematologic and serological evaluation did not disclose an alternative cause for the agranulocytosis. After receiving empirical antibiotic treatment, she responded successfully with clinical improvement of her symptoms and resolved neutropenia on the seventh day. This case is atypical because agranulocytosis developed after discontinuation of MMI, which strengthens the importance of remaining alert for signs of agranulocytosis even after discontinuation of ATD treatment.

References

May 1, 1989·Clinical Endocrinology·H TamaiS Nagataki
Oct 1, 1986·Endocrinologia Japonica·Y OkamuraT Tatsuhara
Nov 22, 1984·The New England Journal of Medicine·D S Cooper
Apr 1, 1995·The Journal of Clinical Endocrinology and Metabolism·S MoritaM Matsuda
Jul 10, 2004·Thyroid : Official Journal of the American Thyroid Association·Junichi Tajiri, Shiro Noguchi
Sep 24, 2013·The Journal of Clinical Endocrinology and Metabolism·Hirotoshi NakamuraJunichi Imagawa
Aug 15, 2014·Experimental and Therapeutic Medicine·Xiao-Su BaiShao-Mei Xiao

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BETA
pregnancy test
biopsy
bone

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