Management of a pregnant patient with Graves' disease complicated by thionamide-induced neutropenia in the first trimester

Clinical Endocrinology
S DavisonP Perros

Abstract

A 31-year-old woman presented with neutropenia due to thionamide drug therapy for Graves' disease. She also reported 8 weeks of amenorrhoea and had a positive pregnancy test. Her drug therapy was discontinued and her neutropenia resolved uneventfully. The hyperthyroidism recurred a week later. After consideration of all treatment options, it was decided to observe until 14 weeks when an elective thyroidectomy was planned. Mother and fetus were monitored closely and both tolerated moderate hyperthyroidism well. At 14 weeks the patient underwent a total thyroidectomy after rendering her euthyroid with a short course of sodium ipodate. Labour was induced at 41 weeks. Delivery was complicated by fetal distress and precipitated a forceps delivery. A 3250 g male infant was born with poor Apgar score and required 2 h of ventilation. At 1 year, the child had reached all developmental milestones at appropriate times. Both mother and fetus may tolerate moderate thyrotoxicosis well in early pregnancy, an alternative that should be considered when thionamide drug therapy is contraindicated.

References

Oct 15, 1979·American Journal of Obstetrics and Gynecology·S C PruynG C Buchanan
Jan 1, 1991·Acta Obstetricia Et Gynecologica Scandinavica·I H SherifS M Carrascal
Nov 1, 1991·Clinical Endocrinology·A BaezaG Pineda
Jan 1, 1991·The Medical Clinics of North America·G P Becks, G N Burrow
Aug 29, 1985·The New England Journal of Medicine·G N Burrow
Jul 8, 1998·The Australian & New Zealand Journal of Obstetrics & Gynaecology·H WarkC Tippett
Oct 20, 1998·Thyroid : Official Journal of the American Thyroid Association·D Glinoer
Nov 27, 1998·The Medical Journal of Australia·M P Austin, P B Mitchell

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Citations

Jul 6, 2007·Irish Journal of Medical Science·F M FinucaneB T Kinsley
Jun 13, 2012·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Ilana L ParkesYoel Shufaro
Feb 7, 2002·Pharmacoepidemiology and Drug Safety
Jul 29, 2010·Obstetrics and Gynecology·Ally MurjiMathew Sermer
Nov 2, 2006·Obstetrics and Gynecology·Brian M Casey, Kenneth J Leveno
Jun 17, 2006·Therapeutic Drug Monitoring·Thien-Giang Bach-Huynh, Jacqueline Jonklaas
Apr 1, 2020·Expert Opinion on Drug Safety·Thanuya FrancisOnyebuchi E Okosieme
Aug 13, 2008·Neurocritical Care·Paul NyquistMarek A Mirski
Jul 26, 2013·Obstetrics and Gynecology·Saly K ThomasScott W Roberts

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