Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature
Context. To report a patient with hyperthyroidism who developed concurrent occurrence of agranulocytosis and severe hepatotoxicity after taking methimazole (MMI). Case. A 51-year-old Chinese male was diagnosed as hyperthyroidism with normal white blood count and liver function. After 4 weeks’ treatm...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/934726 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850221940973764608 |
|---|---|
| author | Jun Yang Jun Zhang Qin Xu Guo-ping Sheng Wan-wen Weng Meng-jie Dong |
| author_facet | Jun Yang Jun Zhang Qin Xu Guo-ping Sheng Wan-wen Weng Meng-jie Dong |
| author_sort | Jun Yang |
| collection | DOAJ |
| description | Context. To report a patient with hyperthyroidism who developed concurrent occurrence of agranulocytosis and severe hepatotoxicity after taking methimazole (MMI). Case. A 51-year-old Chinese male was diagnosed as hyperthyroidism with normal white blood count and liver function. After 4 weeks’ treatment with MMI 20 mg/d, it developed to agranulocytosis and severe cholestatic hepatotoxicity. The patient’s symptoms and laboratory abnormalities disappeared after the withdrawal of MMI; his white blood count and liver function recover to normal in 2 weeks and 5 weeks, respectively. 296 MBq dose of 131I was given to the patient 3 weeks after the withdrawal of MMI and his thyroid function was back to normal in 6 months. As we know through literature review, only 5 previous cases reported the synchronous ATD-induced agranulocytosis and severe hepatotoxicity in patients with hyperthyroidism. Methods. Review of the patient’s clinical course. Literature review of cases of hyperthyroidism with agranulocytosis and severe hepatotoxicity demonstrated that these complications occurred after taking antithyroid drug (ATD). Conclusions. Patient with hyperthyroidism can have synchronous ATD-induced agranulocytosis and severe hepatotoxicity. This case is extremely rare, but the adverse effects with ATDs is clinically significant. The clinicians need to be careful about this and monitor biochemical of patients who take ATDs. |
| format | Article |
| id | doaj-art-7149fa46f6bf490c831e0170d0280046 |
| institution | OA Journals |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-7149fa46f6bf490c831e0170d02800462025-08-20T02:06:31ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/934726934726Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the LiteratureJun Yang0Jun Zhang1Qin Xu2Guo-ping Sheng3Wan-wen Weng4Meng-jie Dong5The Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, ChinaThe Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, ChinaThe Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, ChinaCollaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, ChinaThe Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, ChinaThe Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, ChinaContext. To report a patient with hyperthyroidism who developed concurrent occurrence of agranulocytosis and severe hepatotoxicity after taking methimazole (MMI). Case. A 51-year-old Chinese male was diagnosed as hyperthyroidism with normal white blood count and liver function. After 4 weeks’ treatment with MMI 20 mg/d, it developed to agranulocytosis and severe cholestatic hepatotoxicity. The patient’s symptoms and laboratory abnormalities disappeared after the withdrawal of MMI; his white blood count and liver function recover to normal in 2 weeks and 5 weeks, respectively. 296 MBq dose of 131I was given to the patient 3 weeks after the withdrawal of MMI and his thyroid function was back to normal in 6 months. As we know through literature review, only 5 previous cases reported the synchronous ATD-induced agranulocytosis and severe hepatotoxicity in patients with hyperthyroidism. Methods. Review of the patient’s clinical course. Literature review of cases of hyperthyroidism with agranulocytosis and severe hepatotoxicity demonstrated that these complications occurred after taking antithyroid drug (ATD). Conclusions. Patient with hyperthyroidism can have synchronous ATD-induced agranulocytosis and severe hepatotoxicity. This case is extremely rare, but the adverse effects with ATDs is clinically significant. The clinicians need to be careful about this and monitor biochemical of patients who take ATDs.http://dx.doi.org/10.1155/2015/934726 |
| spellingShingle | Jun Yang Jun Zhang Qin Xu Guo-ping Sheng Wan-wen Weng Meng-jie Dong Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature International Journal of Endocrinology |
| title | Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature |
| title_full | Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature |
| title_fullStr | Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature |
| title_full_unstemmed | Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature |
| title_short | Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature |
| title_sort | unusual synchronous methimazole induced agranulocytosis and severe hepatotoxicity in patient with hyperthyroidism a case report and review of the literature |
| url | http://dx.doi.org/10.1155/2015/934726 |
| work_keys_str_mv | AT junyang unusualsynchronousmethimazoleinducedagranulocytosisandseverehepatotoxicityinpatientwithhyperthyroidismacasereportandreviewoftheliterature AT junzhang unusualsynchronousmethimazoleinducedagranulocytosisandseverehepatotoxicityinpatientwithhyperthyroidismacasereportandreviewoftheliterature AT qinxu unusualsynchronousmethimazoleinducedagranulocytosisandseverehepatotoxicityinpatientwithhyperthyroidismacasereportandreviewoftheliterature AT guopingsheng unusualsynchronousmethimazoleinducedagranulocytosisandseverehepatotoxicityinpatientwithhyperthyroidismacasereportandreviewoftheliterature AT wanwenweng unusualsynchronousmethimazoleinducedagranulocytosisandseverehepatotoxicityinpatientwithhyperthyroidismacasereportandreviewoftheliterature AT mengjiedong unusualsynchronousmethimazoleinducedagranulocytosisandseverehepatotoxicityinpatientwithhyperthyroidismacasereportandreviewoftheliterature |