Two Cases of Methimazole-Induced Agranulocytosis With Their Risk Factors

• DOI: 10.1016/j.aace.2021.10.005
• Publication Date: 2021-11-03T08:28:51Z
• Authors: Aye Khine; Kiranjit Dhillon; Linda Jo; Vanessa Wormser; Soe Naing; Shreela Mishra
• Keywords: Past medical history

Antithyroid drugs, such as methimazole (MMI), are standard therapies for the medical management of thyrotoxicosis. Agranulocytosis is a rare but lethal adverse effect antithyroid medications. We have reported 2 cases MMI-induced agranulocytosis with similar risk factors that likely predisposed them to this reaction.Case 1 involved 71-year-old woman, history Graves disease, who presented an altered mental status. She was recently discharged on 40 mg MMI twice daily, and she continued dose months. readmitted found neutropenic fever in setting agranulocytosis. discontinued, started filgrastim. Her cell counts gradually improved, subsequently discharged.Case 68-year-old severe back pain, nausea, vomiting. 10 which increased 3 times day. hospital because septic shock pneumonia, colitis, bacteremia, A bone marrow biopsy showed polyclonal infiltrate up 85% plasma cells. Despite treatment antibiotics, filgrastim, continuous renal replacement therapy, ultimately passed away.Although these had differing outcomes, they shared features factors, including older age, female sex, relatively higher doses MMI.Close follow awareness MMI, may decrease fatal outcomes.