Agranulocitose e tonsilite associadas ao uso de metimazol

Abstract

The treatment of hyperthyroidism with antithyroid drugs can cause a significant side effect in 0.2 to 0.3% of the cases: agranulocytosis. Infectious complications caused by this condition affect mainly the throat, and tonsillitis is one of its manifestations. The present study reported the case of a female patient, 33 years old, manifesting odynophagia and fever resistant to many antibiotics. The patient showed hyperthyroidism and had been using methimazole for two months. With the diagnoses of agranulocytic angina, the drug was withdrawn and treatment with ciprofloxacin, symptomatic drugs and granulocytic-colony stimulator, besides fluconazol was started. The patient developed satisfactorily, being discharged ten days after the beginning of the treatment. Fifteen days later, total thyroidectomy was carried out. The purpose of this report was to point out the importance of knowing the side effects of drugs to advise the patients about them and to warn physicians about the need for evaluating the patient as a whole, searching for other current diseases and drugs in use.Rev Bras Otorrinolaringol.

Agranulocytosis induced by multidrug therapy in leprosy treatment: a case report

“…Fifty per cent of these patients will have a well-established or occult infection, and at least 20% of the patients with <100/mm³ neutrophils are found to have bacteremia [6]. Once the site of infection is established, it is imperative to start treatment with a broad-spectrum antibiotic and supportive therapy [7]. Healthcare personnel should be made aware of the need for diagnosis and management of adverse effects of these drugs [5].…”

Infección oral y cervicofacial por agranulocitosis secundario debido al tratamiento con medicación antitiroidea: Reporte de Caso

“…Las infecciones tienden a agravarse con bastante rapidez y los agentes más comunes son los Gram negativos. La identificación de agranulocitosis mediante un resultado de hemograma completo requiere manejo médico con antibióticos de amplio espectro, especialmente contra las Pseudomonas aeruginosa, así como terapia de apoyo (8,9). Se reporta como parte del tratamiento al factor estimulante de colonias de granulocitos (G-CSFfilgrastim), que se puede utilizar por vía subcutánea en el segundo y tercer día de hospitalización, con el fin de aumentar el recuento de neutrófilos y reducir el tiempo de recuperación (10,11).…”