methimazole and Pharyngitis

Topics: Adult; Anti-Bacterial Agents; Antithyroid Agents; Bone Marrow; Bone Marrow Diseases; Drug Therapy, Combination; Female; Gingival Hemorrhage; Graves Disease; Humans; Methimazole; Pancytopenia; Pharyngitis; Plasma Cells; Thyroidectomy; Tonsillitis

Three patients, females aged 62, 67 and 32 years, were presented with fever and sore throat and had severe agranulocytosis (granulocyte count < 100/microliter). All had Graves' disease and were being treated with thiamazole 30 mg once a day. Thiamazole was discontinued and treatment with antibiotics initiated. None of the patients received granulocyte-colony stimulating factor (G-CSF). The mean recovery time of granulocytes was 9 days and there were no fatalities. Patients who receive antithyroid agents should be warned against the serious and potentially lethal side effect of agranulocytosis.

Topics: Adult; Aged; Agranulocytosis; Antithyroid Agents; Bone Marrow Examination; Female; Fever; Graves Disease; Humans; Methimazole; Middle Aged; Pharyngitis; Remission Induction; Sepsis

Topics: Aged; Agranulocytosis; Antithyroid Agents; Female; Fever; Graves Disease; Humans; Methimazole; Pharyngitis

Seventy-three cases of thyrotoxicosis were treated at Lloyd Noland Hospital with methimazole, propylthiouracil or both. Two cases of agranulocytosis occurred (2.7%) secondary to methimazole. Both responded to hospitalization, reverse isolation, and antibiotic coverage with complete recovery of the peripheral blood picture. The toxicity of methimazole is noted. The need for careful monitoring of blood counts during therapy and immediate discontinuance of the drug at the first clinical sign of granulocytopenia is stressed.

Topics: Adult; Agranulocytosis; Anti-Bacterial Agents; Blood Cell Count; Female; Humans; Hyperthyroidism; Methimazole; Pharyngitis