Mezquita P, Luna V, Muñoz-Torres M, Torres-Vela E, Lopez-Rodriguez F, Callejas J L, Escobar-Jimenez F
Endocrine Unit, University Hospital of Granada, Spain.
Thyroid. 1998 Sep;8(9):791-4. doi: 10.1089/thy.1998.8.791.
The major adverse reactions of antithyroid drugs are hematologic; aplastic anemia (AA) is one of the rarest and most severe complications. Use of recombinant human hemopoietic colony-stimulating factor was reported to be of benefit in patients who developed agranulocytosis, although there is still some doubt regarding the efficacy in AA. We present a case of a 58-year-old female patient with Graves' disease who developed AA in the third exposure to methimazole (MMI). The withdrawal of MMI and early treatment with 5 microg/kg per day recombinant human granulocyte colony-stimulating factor (G-CSF) for 9 days, allowed a favorable recovery of peripheral blood cell count. We conclude that the use of hemopoietic colony stimulating factors might be a suitable means to achieve the correction of severe thionamide-induced hematologic adverse reactions.
抗甲状腺药物的主要不良反应是血液学方面的；再生障碍性贫血（AA）是最罕见且最严重的并发症之一。据报道，重组人造血集落刺激因子对发生粒细胞缺乏症的患者有益，尽管其对再生障碍性贫血的疗效仍存在一些疑问。我们报告一例58岁患有格雷夫斯病的女性患者，在第三次服用甲巯咪唑（MMI）时发生了再生障碍性贫血。停用MMI并每天以5微克/千克的剂量早期使用重组人粒细胞集落刺激因子（G-CSF）治疗9天，使外周血细胞计数得以良好恢复。我们得出结论，使用造血集落刺激因子可能是纠正硫代酰胺引起的严重血液学不良反应的合适方法。
