Bessembinders Kirsten M, Brinkers J M Mariska, van der Linden Paul D, van Keulen Kris, de Sonnaville Jeroen J J
Tergooiziekenhuizen, Afd. Interne Geneeskunde, Hilversum, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(25):A6351.
Agranulocytosis is a rare but dreaded side-effect of thiamazole. A 61-year-old woman presented at the emergency department with fever and dyspnoea. Because she had recently started therapy with thiamazole for hyperthyroidism, a case of agranulocytosis was feared. Laboratory findings did indeed reveal an absolute neutrophil count of zero. Broad-spectrum antibiotics were given immediately, granulocyte-colony stimulating factor was started and she was admitted to the ICU for supportive care. Unfortunately, she died a day after admission. In this case report, we wanted to place the focus on the importance of this severe side-effect. We emphasize the value of warning the patient, preferably in writing, about the risk of agranulocytosis. We also draw attention to the fact that every doctor must know about agranulocytosis. In this case, the patient consulted her family doctor because she had a sore throat and fever, but was admitted to the hospital only three days after the onset of the symptoms. We believe the risk of agranulocytosis should be understood by every doctor and that the publication of many cases such as this could help heighten general awareness of possibly fatal side-effects like agranulocytosis.
粒细胞缺乏症是甲巯咪唑一种罕见但可怕的副作用。一名61岁女性因发热和呼吸困难就诊于急诊科。由于她最近开始使用甲巯咪唑治疗甲状腺功能亢进症，担心出现粒细胞缺乏症。实验室检查结果确实显示绝对中性粒细胞计数为零。立即给予广谱抗生素，开始使用粒细胞集落刺激因子，并将她收入重症监护病房进行支持治疗。不幸的是，她在入院一天后死亡。在本病例报告中，我们想强调这种严重副作用的重要性。我们强调最好以书面形式告知患者粒细胞缺乏症风险的价值。我们还提请注意每个医生都必须了解粒细胞缺乏症这一事实。在本病例中，患者因喉咙痛和发热咨询了她的家庭医生，但直到症状出现三天后才入院。我们认为每个医生都应该了解粒细胞缺乏症的风险，并且公布许多这样的病例有助于提高公众对粒细胞缺乏症等可能致命副作用的普遍认识。
