Lei Xiaotian, Leng Weiling, Long Min, Xie Laiping, Chen Liu
Department of Endocrinology, First Affiliated Hospital of Army Medical University, Chongqing 400038.
Department of Nuclear Medicine, First Affiliated Hospital of Army Medical University, Chongqing 400038, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Jul 28;49(7):1089-1094. doi: 10.11817/j.issn.1672-7347.2024.240372.
Antithyroid drugs can cause neutropenia or agranulocytosis, rarely pancytopenia in hyperthyroidism therapy. The treatment is difficult and lethality is high when granulocytopenia or pancytopenia combined with hyperthyroidism crisis. First Affiliated Hospital of Army Medical University treated a patient who had pancytopenia caused by methimazole with systemic lupus erythematosus, secondary hyperthyroidism crisis and agranulocytosis.We gave the reasonable treatment in time, such as anti-infection, stimulating granulocyopoiesis, compound iodine solution to control thyroid function, controlled the disease effectively and saved the patient's life. Early detection and identification of possible causes of pancytopenia and dynamic adjustment of treatment plan show great significance for patients with hyperthyroidism and severe pancytopenia.
抗甲状腺药物在治疗甲状腺功能亢进时可导致中性粒细胞减少或粒细胞缺乏症,很少引起全血细胞减少。当粒细胞减少或全血细胞减少合并甲状腺功能亢进危象时,治疗困难且致死率高。陆军军医大学第一附属医院治疗了1例因甲巯咪唑导致全血细胞减少,合并系统性红斑狼疮、继发性甲状腺功能亢进危象及粒细胞缺乏症的患者。我们及时给予了合理治疗,如抗感染、刺激粒细胞生成、复方碘溶液控制甲状腺功能,有效控制了病情,挽救了患者生命。早期发现并识别全血细胞减少的可能病因,动态调整治疗方案,对甲状腺功能亢进合并严重全血细胞减少的患者具有重要意义。