Characteristics of Agranulocytosis as an Adverse Effect of Antithyroid Drugs in the Second or Later Course of Treatment

Thyroid ◽  
2014 ◽  
Vol 24 (5) ◽  
pp. 796-801 ◽  
Author(s):  
Sakiko Kobayashi ◽  
Jaeduk Yoshimura Noh ◽  
Koji Mukasa ◽  
Yo Kunii ◽  
Natsuko Watanabe ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Antithyroid Drugs

scholarly journals Development of Agranulocytosis after Discontinuation of Methimazole: An Unusual Case

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Rıfkı Üçler ◽  
Murat Atmaca ◽  
Ömer Candar ◽  
Murat Alay ◽  
Burhan Göy ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Clinical Improvement ◽  
Unusual Case ◽  
Antithyroid Drugs ◽  
Upper Respiratory Tract ◽  
Empirical Antibiotic Treatment ◽  
Upper Respiratory

Agranulocytosis is a rare and critical adverse effect of antithyroid drugs (ATD). The occurrence of agranulocytosis in continuous ATD treatment patients is well known; however, a case of ATD agranulocytosis occurring following the discontinuation of methimazole (MMI) treatment is not a usual situation. We herein describe a case of a 41-year-old woman who was previously administered methimazole (MMI) for ten days and developed ATD-induced agranulocytosis and symptoms of an upper respiratory tract infection after three weeks following discontinuation of MMI treatment. A thorough hematologic and serological evaluation did not disclose an alternative cause for the agranulocytosis. After receiving empirical antibiotic treatment, she responded successfully with clinical improvement of her symptoms and resolved neutropenia on the seventh day. This case is atypical because agranulocytosis developed after discontinuation of MMI, which strengthens the importance of remaining alert for signs of agranulocytosis even after discontinuation of ATD treatment.

Systemic Adverse Effect of Antithyroid Drugs

1999 ◽  
Vol 18 (1) ◽  
pp. 66-68 ◽  
Author(s):  
E. Mathieu ◽  
O. Fain ◽  
M. Sitbon ◽  
M. Thomas
Keyword(s):  
Adverse Effect ◽  
Systemic Adverse Effect ◽  
Antithyroid Drugs

A Case Report on Methimazole Induced Anti-Thyroid Arthritis Syndrome: A Rare Drug Induced Migratory Polyarthritis

2021 ◽  
pp. 5483-5488
Author(s):  
Aiswarya Mohan ◽  
Aravind H ◽  
Chakravarthy S Maddipati ◽  
Roshni P R
Keyword(s):  
Adverse Effect ◽  
Case Reports ◽  
Antithyroid Drugs ◽  
Drug Discontinuation ◽  
Graves Disease ◽  
Drug Induced ◽  
Laboratory Findings ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Migratory Polyarthritis

Antithyroid drugs (ATD’s) are widely used as the first line treatment option for the management of hyperthyroidism, especially for patients with Graves’ disease. They are classified into thionamide (Methimazole, Carbimazole and Propylthiouracil) and Non-thionamide (Iodine containing compounds) ATD’s. These drugs are associated with various types of adverse effects ranging from mild to potentially life threatening. Antithyroid arthritis syndome (AAS) is one of the major and uncommon side effects of ATD therapy requiring immediate drug discontinuation and hospitalization presents itself with myalgia, arthralgia and arthritis along with fever and rash of varying severity and non-specific laboratory findings, making its diagnosis and management clinically challenging. Here we report the case of 32 year old female with Graves’ disease who experienced severe migratory polyarthritis after the initiation of methimazole therapy. Her symptoms started to disappear after the prompt withdrawal of methimazole. We also concluded that this adverse effect of ATD’s might not be dose dependent by comparing our case with 6 other case reports of AAS. Here our objective is to raise awareness among the clinicians regarding the differential diagnosis and management of this major, uncommon and potentially life threatening adverse effect of ATD therapy.

scholarly journals Outcome of treatment with thionamides and its adverse effects in patients with graves' disease

2019 ◽  
Author(s):  
Isabella Lucca de Campos Lima ◽  
Denise Engelbrecht Zantut Wittmann ◽  
Isabela Sayuri Okuma ◽  
Arnaldo Moura Neto ◽  
Marcos Antonio Tambascia
Keyword(s):  
Adverse Effect ◽  
Autoimmune Disease ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Main Determinant ◽  
Referral Center ◽  
High Concentrations ◽  
Predictor Factor

Graves' disease is an autoimmune disease and is the main cause of hyperthyroidism. This study aims to characterize the evolution of treatment with antithyroid drugs in patients with Graves' disease in a tertiary care referral center. We observed that the use of propylthiouracil was a predictor factor of a greater chance of having some adverse effect in relation to the use of methimazole. Regarding the evolution of treatment, high concentrations of TRAb were the main determinant for non-remission of the disease with the use of thionamides.

The Resolution and Contrast in Biological Sections Determined by Inelastic and Elastic Scattering

1973 ◽  
Vol 31 ◽  
pp. 224-225
Author(s):  
D. L. Misell
Keyword(s):  
Electron Microscopy ◽  
Adverse Effect ◽  
Elastic Scattering ◽  
Inelastic Scattering ◽  
Amorphous Carbon ◽  
Polymeric Materials ◽  
Chromatic Aberration ◽  
Image Resolution ◽  
Quantitative Estimates ◽  
Elastic Ratio

In the electron microscopy of biological sections the adverse effect of chromatic aberration on image resolution is well known. In this paper calculations are presented for the inelastic and elastic image intensities using a wave-optical formulation. Quantitative estimates of the deterioration in image resolution as a result of chromatic aberration are presented as an alternative to geometric calculations. The predominance of inelastic scattering in the unstained biological and polymeric materials is shown by the inelastic to elastic ratio, I/E, within an objective aperture of 0.005 rad for amorphous carbon of a thickness, t=50nm, typical of biological sections; E=200keV, I/E=16.

Eligible or Ineligible: Determining Adverse Effect

2002 ◽  
Vol 3 (2) ◽  
pp. 26-28
Author(s):  
Linda S. Bowman ◽  
C. Al Bowman ◽  
Rita L. Bailey
Keyword(s):  
Adverse Effect

Graves'-Basedow disease in pregnancy

2015 ◽  
Vol 54 (03) ◽  
pp. 106-111 ◽  
Author(s):  
S. L. Andersen ◽  
P. Laurberg
Keyword(s):  
Side Effects ◽  
Birth Defects ◽  
Thyroid Dysfunction ◽  
National Study ◽  
Antithyroid Drugs ◽  
Upper Limit ◽  
Special Concern ◽  
Maternal Thyroid ◽  
Toxic Reactions ◽  
Serum Tsh

SummaryThyroid hormones are essential development factors and maternal thyroid dysfunction may cause pregnancy complications and diseases in the fetus/child. In the present review we discuss new data on the incidence of Graves'-Basedow disease (GBD) in and around pregnancy, and how hyperthyroidism may affect the risk of spontaneous abortion and stillbirth.A special concern in pregnant women is the potential side effects from the use of antithyroid drugs (ATDs). One type of side effects is the allergic/toxic reactions to the drugs, which seem to be similar in and outside pregnancy, and another is that ATDs tend to over treat the fetus when the mother with GBD is made euthyroid. To avoid fetal hypothyroidism, the lowest possible ATD dose should be used to keep maternal thyroid function at the upper limit of normality with low serum TSH. Birth defects after the use of methimazole (MMI) (or its prodrug carbimazole) have been considered to be very rare, and no risk has previously been associated with the use of propylthiouracil (PTU). However, a recent Danish national study found that 1/30 of children exposed to MMI in early pregnancy had birth defects associated with this, and many defects were severe. PTU exposure was associated with defects in 1/40, and these defects were less severe. Proposals are given on how to reduce the risk of ATD associated birth defects.

Guideline for radioiodine therapy for benign thyroid diseases (version 3)

2004 ◽  
Vol 43 (06) ◽  
pp. 217-220 ◽  
Author(s):  
J. Dressler ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
Chr. Reiners ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Thyroid Diseases ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Co Morbidity ◽  
History Of ◽  
Individual Decisions ◽  
Prophylactic Use ◽  
Benign Thyroid

SummaryThe version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves’ disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves’ disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient’s preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients’ preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3rd version.

Early change of thyroid hormone concentration after 131I treatment in patients with solitary toxic adenoma

2002 ◽  
Vol 41 (04) ◽  
pp. 178-183 ◽  
Author(s):  
V. Fidler ◽  
K. Zaletel ◽  
S. Gaberšček ◽  
S. Hojker ◽  
E. Pirnat
Keyword(s):  
Thyroid Hormone ◽  
Antithyroid Drugs ◽  
Prospective Clinical Study ◽  
Hormone Concentration ◽  
Toxic Adenoma ◽  
Free Triiodothyronine ◽  
Thyroid Cells ◽  
131I Treatment ◽  
Before And After ◽  
Thyroid Hormone Concentration

Summary Aim: In spite of extensive use of 131I for treatment of hyperthyroidism, the results of early outcome are variable. In our prospective clinical study we tested whether 131I induced necrosis causing clinical aggravation of hyperthyroidism and increasing the free thyroid hormone concentration in the serum of patients with solitary toxic adenoma not pretreated with antithyroid drugs. Patients and methods: 30 consecutive patients were treated with 925 MBq 131I. Serum concentration of thyrotropin (TSH), free thyroxine (fT4), free triiodothyronine (fT3), thyroglobulin (Tg), and interleukin-6 (IL-6) were measured before and after application of 131I. Results: After application of 131I no clinical worsening was observed. FT4 and fT3 concentration did not change significantly within the first five days, whereas both of them significantly decreased after 12 days (p <0.0001). Slight and clinically irrelevant increase in the level of the two thyroid hormones was observed in 9 patients. Furthermore, we observed a prolonged increase in Tg concentration and a transient increase in IL-6 concentration. Conclusion: Neither evidence of any clinical aggravation of hyperthyroidism nor any significant increase in thyroid hormone concentration by 131I induced necrosis of thyroid cells was found. Therefore, the application of 131I may be considered as a safe and effective treatment for patients with hyperthyroidism due to toxic adenoma.

Sign in / Sign up

Export Citation Format

Share Document