Use of granulocyte colony‐stimulating factor in the treatment of methimazole‐induced agranulocytosis: a case report

Birmingham, Asha R.; Mancuso, Carissa; Williams, Craig

doi:10.1002/ccr3.1124

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Though randomised-controlled trials are not available, utilisation of G-CSF is generally recommended in these patients. Evidence supports that G-CSF therapy can decrease the length of hospitalisation, duration of antibiotic treatment and expedite WCC normalisation, though there is no proven mortality benefit 11. Time of recovery after development of agranulocytosis varies but is typically within 1 month.…”

Section: Discussionmentioning

confidence: 99%

Concomitant methimazole-induced agranulocytosis and cholestatic jaundice in a young woman

2022

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A woman in her 30s presented to the emergency department with new-onset sore throat and fever. She had recently been diagnosed with Graves’ disease 3 months prior. As a result, she was initiated on atenolol and methimazole for management. Her methimazole dosing had been stable at 15 mg daily for the month prior to presentation. Investigation revealed severe neutropenia and jaundice. She was found to have concomitant agranulocytosis and cholestatic jaundice secondary to methimazole.Methimazole was discontinued on admission and the patient received granulocyte colony-stimulating factor for an absolute neutrophil count (ANC) of zero. She was placed on broad-spectrum antibiotics and intravenous steroids for epiglottic and supraglottic oedema noted on bedside laryngoscopy. ANC and bilirubin improved over a 2-week hospital course. She was discharged on a temporary regimen of propranolol, dexamethasone and potassium iodide until she was able to undergo successful thyroidectomy for definitive management of Graves’ disease outpatient.

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Section: Discussionmentioning

confidence: 99%

Concomitant methimazole-induced agranulocytosis and cholestatic jaundice in a young woman

2022

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Thiamazole

2017

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Metamizole‑affected onset of action of filgrastim

Oleárová¹,

Jurečková²

2019

Klin Farmakol Farm

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Ústav farmakológie a klinickej farmakológie, Lekárska fakulta, Slovenská zdravotnícka univerzita v Bratislave Metamizol je jedno z najpoužívanejších analgetík, ktoré sa vyznačuje aj antipyretickými a spazmolytickými účinkami. Vo viacerých krajinách sa metamizol nepoužíva pre riziko vzniku agranulocytózy. V článku opisujeme kazuistiku 72-ročnej pacientky hospitalizovanej so závažnou pancytopéniou. Zaznamenali sme u nej oneskorený nástup účinku filgrastímu v dôsledku súčasne podávaného metamizolu. Na základe revízie farmakoterapie bol z liečby rizikový metamizol vysadený. Po úprave farmakoterapie a podaní ďalších dvoch dávok filgrastímu počty leukocytov a neutrofilov uspokojivo stúpli. Po podaní podpornej liečby krvnými derivátmi sa stav pacientky postupne zlepšil a v stabilizovanom stave bola z nemocnice prepustená.

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Use of granulocyte colony‐stimulating factor in the treatment of methimazole‐induced agranulocytosis: a case report

Abstract: A comparison of this case to previously published reports suggests that granulocyte colony-stimulating factor may be associated with improved prognosis in severe antithyroid drug-induced neutropenia, and that weight-based doses could be an appropriate strategy.

Cited by 3 publications

References 24 publications

Concomitant methimazole-induced agranulocytosis and cholestatic jaundice in a young woman

Concomitant methimazole-induced agranulocytosis and cholestatic jaundice in a young woman

Thiamazole

Metamizole‑affected onset of action of filgrastim

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