Zambrana Jorge T, Zambrana Fábio F T, Neto Firmino R S, Gonçalves André L C, Zambrana Fernanda F T, Ushirohira Jorge
Faculdade de Medicina de Itajubá.
Braz J Otorhinolaryngol. 2005 May-Jun;71(3):374-7. doi: 10.1016/s1808-8694(15)31339-2. Epub 2005 Dec 14.
he treatment of hyperthyroidism with antithyroid drugs can cause a significant side effect in 0.2 to 0.3% of the cases: agranulocytosis. Infectious complications caused by this condition affect mainly the throat, and tonsillitis is one of its manifestations. The present study reported the case of a female patient, 33 years old, manifesting odynophagia and fever resistant to many antibiotics. The patient showed hyperthyroidism and had been using methimazole for two months. With the diagnoses of agranulocytic angina, the drug was withdrawn and treatment with ciprofloxacin, symptomatic drugs and granulocytic-colony stimulator, besides fluconazol was started. The patient developed satisfactorily, being discharged ten days after the beginning of the treatment. Fifteen days later, total thyroidectomy was carried out. The purpose of this report was to point out the importance of knowing the side effects of drugs to advise the patients about them and to warn physicians about the need for evaluating the patient as a whole, searching for other current diseases and drugs in use.
使用抗甲状腺药物治疗甲状腺功能亢进症时,在0.2%至0.3%的病例中会出现一种严重的副作用:粒细胞缺乏症。这种情况引起的感染性并发症主要影响咽喉部,扁桃体炎是其表现之一。本研究报告了一名33岁女性患者的病例,该患者表现为吞咽痛和对多种抗生素耐药的发热。患者患有甲状腺功能亢进症,已使用甲巯咪唑两个月。在诊断为粒细胞缺乏性咽峡炎后,停用了该药物,并开始使用环丙沙星、对症药物、粒细胞集落刺激因子以及氟康唑进行治疗。患者病情发展良好,治疗开始十天后出院。十五天后,进行了甲状腺全切除术。本报告的目的是指出了解药物副作用的重要性,以便向患者提供相关建议,并提醒医生有必要对患者进行全面评估,查找其他当前疾病和正在使用的药物。