Related Experiment Video

Updated: Mar 15, 2026

The Clinical Application of Tumor Treating Fields Therapy in Glioblastoma
08:00

The Clinical Application of Tumor Treating Fields Therapy in Glioblastoma

Published on: April 16, 2019

19.5K

Delayed methimazole-induced agranulocytosis in a 6-year old patient with Graves' disease

Vidya Puthenpura1, Kinjal Desai1, Andrew Bauer2

  • 1Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, 89 French Street, New Brunswick, NJ 08901 USA.

International Journal of Pediatric Endocrinology
|September 9, 2016
PubMed

Insights

Methimazole (MMI) can cause agranulocytosis, a rare side effect. This case highlights a child developing this serious condition 18 months into MMI therapy, beyond the typical timeframe.

Area of Science:

  • Pediatric Endocrinology
  • Pharmacovigilance

Background:

  • Methimazole (MMI) is a common treatment for Graves' disease.
  • Agranulocytosis is a rare, typically early-onset side effect of MMI therapy.
  • Delayed MMI-induced agranulocytosis is seldom reported in pediatric patients.

Observation:

  • A 6-year-old patient developed agranulocytosis.
  • The adverse event occurred 18 months after initiating MMI therapy.
  • The patient was on a stable MMI dose when agranulocytosis manifested.

Findings:

  • This case represents a delayed presentation of MMI-induced agranulocytosis in a child.
  • Literature review indicates inconclusive data on MMI-induced agranulocytosis timelines in pediatric Graves' disease.
  • The dose-dependency and incidence in children remain poorly understood.

Implications:

  • Highlights the need for vigilance regarding delayed MMI side effects in pediatric patients.
  • Suggests that MMI therapy may require extended monitoring for agranulocytosis, irrespective of initial treatment duration.
  • Underscores the necessity for further research into MMI-induced agranulocytosis in pediatric populations.
Abstract

Keywords:
Absolute neutrophil countAgranulocytosisGraves’ diseaseMethimazole

More Related Videos

In Vivo Inhibition of MicroRNA to Decrease Tumor Growth in Mice07:02

In Vivo Inhibition of MicroRNA to Decrease Tumor Growth in Mice

Published on: August 23, 2019

7.8K
Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice05:10

Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice

Published on: October 3, 2010

12.7K

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
639
Myasthenia Gravis: Overview and Treatment01:20

Myasthenia Gravis: Overview and Treatment

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
3.3K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
312
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
351
Hypersensitivity Reactions: Delayed Hypersensitivity Reactions01:29

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...
119