Abstract
Agranulocytosis is an infrequent and serious side effect of antithyroid drugs characterized by a noticeable reduction in granulocyte and neutrophil count, it usually occurs within the first 2-3 months of treatment. There is a variety of mechanisms by which ATD can induce agranulocytosis, direct drug effects, and immunological mechanisms. We present 33 years old female attended Atbara teaching hospital who has developed agranulocytosis 2 weeks after starting ATD to treat relapsed Graves' disease. What was unusual about this patient is that symptoms have occurred in a period less than 15 days of starting treatment and with a dose of 45 mg /day. The physician must educate the patient about the possibility of early onset of serious side effects of ATD and to seek medical advice as soon as possible.
Highlights
Basedow’s (Graves’) sickness is an autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies
We present 33 years old female attended Atbara teaching hospital who has developed agranulocytosis 2 weeks after starting Antithyroid Drug (ATD) to treat relapsed Graves’ disease
33 years old female patient attended to Atbara teaching hospital who is a known case of Graves’ disease underwent subtotal thyroidectomy 14 years ago she has been on thyroxin 50 mg once daily she remained euthyroid all that time till the last month when she developed palpitation, weight loss despite increase appetite, sweating, menstrual irregularity, and irritability. thyroid function test showed (TSH 0.02 μIU/ml, free T3 5.6 ng/ml, T4 2.1 ug/ml) patient was diagnosed as relapsed graves’ disease and received Neomercazole 15 mg three times a day and B blocker for symptoms control, 15 days after initiation of ATD patient has developed a severe sore throat and high-grade fever, she sought medical advice at local ENT center
Summary
Mosab Nouraldein Mohammed Hamad2*, Sarra Osman Bushara, Amel Abdalrhim Sulaiman, Mohamed Adil Yassen Ali, Remaz Khalid Hassan Ahmed, Almotasim Mohamed Aabdelmgid Elnaema, Samaher Mozamil Mohamed Abdelrahim4 1Medicine department, Faculty of Medicine, Nile Valley University, Atbara, Sudan
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