| Abstract | BACKGROUND: Thionamide induced agranulocytosis is associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA) in some patients. This poses a particular challenge when it occurs during pregnancy. AIMS: To report a case of a 31-year-old woman with Graves' disease who presented at 11 weeks gestation with propylthiouracil induced agranulocytosis. METHODS: After cessation of propylthiouracil the patient developed recurrent thyrotoxicosis, and underwent an elective subtotal thyroidectomy at 23 weeks gestation. RESULTS: The patient required postoperative thyroxine replacement therapy. Subsequent pregnancy was uneventful and she delivered a healthy baby boy at 41 weeks gestation. As part of our routine work up for agranulocytosis we measured C-ANCA levels, which were significantly elevated. CONCLUSION: This case highlights the association of propylthiouracil induced ANCA positivity and agranulocytosis. Second trimester subtotal thyroidectomy was safe and effective in treating this pregnant patient's thyrotoxicosis. |
| Authors | F M Finucane, J O'Connell, B T Kinsley
(Affiliation: Department of Endocrinology and Diabetes Mellitus, Mater Misericordiae Hospital, Eccles' Street, Dublin 7, Ireland.)
|
| Journal | Irish journal of medical science
(Ir J Med Sci)
Vol. 177
Issue 1
Pg. 69-71
(Mar 2008)
ISSN: 0021-1265 Ireland |
| PMID | 17611791
(Publication Type: Case Reports, Journal Article)
|
| Chemical References |
- Antibodies, Antineutrophil Cytoplasmic
- Antithyroid Agents
- Propylthiouracil
|
| Topics |
- Adult
- Agranulocytosis
(blood, chemically induced)
- Antibodies, Antineutrophil Cytoplasmic
(blood)
- Antithyroid Agents
(adverse effects)
- Female
- Graves Disease
(diagnosis, drug therapy, surgery)
- Humans
- Pregnancy
- Pregnancy Complications
(diagnosis, drug therapy, surgery)
- Propylthiouracil
(adverse effects)
- Term Birth
- Thyroidectomy
- Thyrotoxicosis
(diagnosis, drug therapy, surgery)
|
