Methimazole-induced aplastic anemia in third exposure: successful treatment with recombinant human granulocyte colony-stimulating factor.

Abstract

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.

• Authors: P Mezquita, V Luna, M Muñoz-Torres, E Torres-Vela, F Lopez-Rodriguez, J L Callejas, F Escobar-Jimenez
• Journal: Thyroid : official journal of the American Thyroid Association (Thyroid) Vol. 8 Issue 9 Pg. 791-4 (Sep 1998) ISSN: 1050-7256 [Print] United States
• PMID: 9777751 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Recombinant Proteins
• Granulocyte Colony-Stimulating Factor
• Methimazole

Topics

• Anemia, Aplastic (chemically induced, diagnosis, pathology)
• Blood Cells (pathology)
• Bone Marrow (pathology)
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Graves Disease (drug therapy)
• Humans
• Methimazole (adverse effects, therapeutic use)
• Middle Aged
• Recombinant Proteins