Stellingwerf Margriet, Jellema Wilbert T, Eland Ingo A, Wakelkamp Iris M M J
St. Antonius ziekenhuis, afd. Interne Geneeskunde, Nieuwegein, the Netherlands.
Ned Tijdschr Geneeskd. 2011;155:A2430.
Agranulocytosis/granulocytopenia is a rare side effect of thyreostatics. Earlier publications state that for thiamazole this side effect occurs during the first few months of treatment. In two patients this thiamazole-induced agranulocytosis/granulocytopenia only occurred after years of treatment. A 53-year-old man presented with fever after a visit to Suriname. He had used thiamazole for 12 years for Graves' hyperthyroidism. The second patient, a 31-year-old woman, presented at the emergency department with fever and sore throat after 13 years of intermittent treatment with thiamazole. Both patients had an agranulocytosis/granulocytopenia and leukopenia. This was thought to be a side effect of thiamazole and blood values normalised after cessation of therapy. Both patients were treated empirically with broad-spectrum antibiotics during the agranylocytic period. They then received radioactive sodium iodide. To our knowledge this case report is the first to describe agranulocytosis/granulocytopenia following long-term treatment with thiamazole.
粒细胞缺乏症/粒细胞减少症是抗甲状腺药物罕见的副作用。早期出版物指出，对于甲巯咪唑，这种副作用发生在治疗的最初几个月。在两名患者中，这种甲巯咪唑引起的粒细胞缺乏症/粒细胞减少症仅在多年治疗后才出现。一名53岁男性在去过苏里南后出现发热。他因格雷夫斯甲状腺功能亢进症服用甲巯咪唑12年。第二名患者是一名31岁女性，在间歇性服用甲巯咪唑13年后，因发热和喉咙痛到急诊科就诊。两名患者均患有粒细胞缺乏症/粒细胞减少症和白细胞减少症。这被认为是甲巯咪唑的副作用，停药后血液值恢复正常。在粒细胞缺乏期，两名患者均接受了经验性广谱抗生素治疗。然后他们接受了放射性碘化钠治疗。据我们所知，本病例报告是首例描述长期服用甲巯咪唑后出现粒细胞缺乏症/粒细胞减少症的报道。
