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[Agranulocytosis with tonsillitis associated with methimazole therapy]
Jorge T Zambrana1, Fábio F T Zambrana, Firmino R S Neto
1Faculdade de Medicina de Itajubá.
Brazilian Journal of Otorhinolaryngology
|February 1, 2006
Summary
Antithyroid drugs like methimazole can cause agranulocytosis, a dangerous drop in white blood cells. This case highlights the importance of recognizing this severe side effect in hyperthyroidism patients.
Area of Science:
- Endocrinology
- Hematology
- Pharmacology
Background:
- Hyperthyroidism is commonly treated with antithyroid drugs.
- Agranulocytosis is a rare but serious side effect of antithyroid drug therapy, occurring in 0.2-0.3% of patients.
- Infectious complications, particularly throat infections like tonsillitis, are common manifestations of agranulocytosis.
Observation:
- A 33-year-old female patient presented with odynophagia and persistent fever, unresponsive to multiple antibiotics.
- The patient had a history of hyperthyroidism and was on methimazole treatment for two months.
- Clinical presentation was consistent with agranulocytic angina.
Findings:
- Methimazole was discontinued upon diagnosis of agranulocytic angina.
- Treatment included ciprofloxacin, symptomatic management, granulocyte-colony stimulating factor, and fluconazole.
- The patient showed satisfactory recovery and was discharged within ten days.
Implications:
- This case underscores the critical need for clinicians to be aware of potential severe side effects of antithyroid medications.
- Patient education regarding drug side effects is crucial for early recognition and intervention.
- A comprehensive patient evaluation, considering concurrent diseases and medications, is essential for optimal management.
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