Agranulocytosis induced by thyrostatics intake


DOI: https://dx.doi.org/10.18565/therapy.2020.8.162-167

Bobrova E.I., Vinogradskaya O.I., Gubernatorova E.E., Pavlova M.G.

1) Medical center «Dimax», Ramenskoye (Moscow region); 2) I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Healthcare of Russia; 3) Hospital of the Centrosojuz of the Russian Federation, Moscow
Current article provides a detailed analysis of a clinical case of severe agranulocytosis in 61-year-old female patient developed during the use of thyrostatic therapy for Graves ‘disease (diffuse toxic goiter, Graves’ disease), grade I. The etiology, pathogenetic mechanisms, principles of diagnosis and treatment of agranulocytosis induced by thyrostatics’ intake are considered, basing on the current data of the scientific literature on this disease.

Literature



  1. Sundaresh V., Brito J.P., Wang Z. et al. Comparative effectiveness of therapies for Graves’ hyperthyroidism: a systematic review and network meta-analysis. J Clin Endocrinol Metab. 2013; 98(9): 3671–77. doi: 10.1210/jc.2013-1954.

  2. Yang J., Zhu Y.J., Zhong J. et al. Characteristics of antithyroid drug-induced agranulocytosis in patients with hyperthyroidism: a retrospective analysis of 114 cases in a single institution in China involving 9690 patients referred for radioiodine treatment over 15 years. Thyroid. 2016; 26(5): 627–33. doi: 10.1089/thy.2015.0439.

  3. Bartels E.C., Sjogren R.W. 1-Methyl-2-mercaptoimidazole: a new active antithyroid agent. J Clin Endocrinol Metab. 1951; 11(10): 1057–62. doi:10.1210/jcem-11-10-1057.

  4. Cooper D.S. Antithyroid drugs. N Engl J Med. 1984; 311: 1353–62.

  5. Vicente N., Cardoso L., Barros L., Carrilho F. Antithyroid drug-induced agranulocytosis: state of the art on diagnosis and management. Drugs R D. 2017; 17(1): 91–96. doi: 10.1007/s40268-017-0172-1.

  6. Boxer L.A. How to approach neutropenia. Hematology Am Soc Hematol Educ Program. 2012; 2012: 174–82. doi:10.1182/asheducation-2012.1.174.

  7. Haddy T.B., Rana S.R., Castro O. Benign ethnic neutropenia: what is a normal absolute neutrophil count? J Lab Clin Med. 1999; 133(1): 15–22. doi:10.1053/lc.1999.v133.a94931.

  8. Andres E., Zimmer J., Affenberger S. et al. Idiosyncratic drug-induced agranulocytosis: update of an old disorder. Eur J Intern Med. 2006; 17(8): 529–35. doi:10.1016/j.ejim.2006.07.012.

  9. Benichou C., Solal Celigny P. Standardization of definitions and criteria for causality assessment of adverse drug reactions. Drug-induced blood cytopenias: report of an international consensus meeting. Nouv Rev Fr Hematol. 1991; 33(3): 257–62.

  10. Nakamura H., Miyauchi A., Miyawaki N., Imagawa J. Analysis of 754 cases of antithyroid drug-induced agranulocytosis over 30 years in Japan. J Clin Endocrinol Metab. 2013; 98(12): 4776–83. doi: 10.1210/jc.2013-2569.

  11. Tajiri J., Noguchi S., Murakami T., Murakami N. Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring. Arch Intern Med. 1990; 150(3): 621–24. doi: 10.1001/archinte.150.3.621.

  12. Andersohn F., Konzen C., Garbe E. Systematic review: agranulocytosis induced by nonchemotherapy drugs. Ann Intern Med. 2007; 146(9): 657–65. doi: 10.7326/0003-4819-146-9-200705010-00009.

  13. Watanabe N., Narimatsu H., Noh J.Y. et al. Antithyroid drug-induced hematopoietic damage: a retrospective cohort study of agranulocytosis and pancytopenia involving 50,385 patients with Graves’ disease. J Clin Endocrinol Metab. 2012; 97(1): E49–53. doi: 10.1210/jc.2011-2221.

  14. Tsuboi K., Ueshiba H., Shimojo M. et al. The relation of initial methimazole dose to the incidence of methimazole-induced agranulocytosis in patients with Graves’ disease. Endocr J. 2007; 54(1): 39–43. doi: 10.1507/endocrj.k05-068.

  15. Lam D.C., Lindsay R.H. Accumulation of 2-[14C]propylthiouracil in human polymorphonuclear leukocytes. Biochem Pharmacol. 1979; 28(15): 2289–99.

  16. Sheng W.H., Hung C.C., Chen Y.C. et al. Antithyroid-drug-induced agranulocytosis complicated by life-threatening infections. QJM. 1999; 92(8): 455–61. doi: 10.1093/qjmed/92.8.455.

  17. Johnston A., Uetrecht J. Current understanding of the mechanisms of idiosyncratic drug-induced agranulocytosis. Expert Opin Drug Metab Toxicol. 2015; 11(2): 243–57. doi: 10.1517/17425255.2015.985649.

  18. Tamai H., Sudo T., Kimura A. et al. Association between the DRB1*08032 histocompatibility antigen and methimazole-induced agranulocytosis in Japanese patients with Graves disease. Ann Intern Med. 1996; 124(5): 490–94. doi: 10.7326/0003-4819-124-5-199603010-00005.

  19. Kobayashi S., Noh J.Y., Mukasa K. et al. Characteristics of agranulocytosis as an adverse effect of antithyroid drugs in the second or later course of treatment. Thyroid. 2014; 24(5): 796–801. doi: 10.1089/thy.2013. 0476.

  20. Fukata S., Kuma K., Sugawara M. Granulocyte colony-stimulating factor (G-CSF) does not improve recovery from antithyroid drug-induced agranulocytosis: a prospective study. Thyroid. 1999; 9(1): 29–31. doi: 10.1089/thy.1999.9.29.


About the Autors


Ekaterina I. Bobrova, PhD, endocrinologist of the Dimax medical center. Address: 140104, Moscow region, Ramenskoe, 25 Levashova Str. Tel.: +7 (926) 402-00-49. E-mail: kekskoffe@yandex.ru
Olga I. Vinogradskaya, PhD, assistant of the Department of endocrinology No. 1 of I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Healthcare of Russia. Address: 119435, Moscow, 1/1 Pogodinskaya Str. Tel.: +7 (499) 248-38-88. E-mail: Thyroclin@gmail.com
Ekaterina E. Gubernatorova, PhD, endocrinologist, Hospital of the Centrosojuz of the Russian Federation, Moscow. Address: 107150, Moscow, 39 Losinoostrovskaya Str. Tel.: +7 (499) 169-74-08. E-mail: creativeone@list.ru
Maria G. Pavlova, PhD., associate professor of the Department of endocrinology No. 1 of I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Healthcare of Russia. Address: 119435, Moscow, 1/1 Pogodinskaya Str. Tel.: +7 (499) 248-38-88. E-mail: Thyroclin@gmail.com


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