Methimazole-Induced Agranulocytosis and Quick Recovery with G-CSF

A 51-year old female, treated for hyperthyroidism with methimazole, developed agranulocytosis in the third month of therapy. After discontinuing the drug, a broad spectrum antibiotic regimen plus recombinant human granulocyte colony-stimulating factor (G-CSF) were started. Her granulocyte count returned to normal with the 4(°) dose of G-CSF. We think that in patients with methimazole-induced agranulocytosis, G-CSF may reduce the risk and severity of infection and in some cases should be accepted as a part of the standard therapy.