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Cited by 88Thyroid Disorders and TreatmentsBlood disorders and treatmentsPharmacovigilance and Adverse Drug Reactions

Antithyroid drug — induced agranulocytosis: Clinical experience with ten patients treated at one institution and review of the literature

Meyer-Geßner, M., Benker, G., Lederbogen, S., Olbricht, T., Reinwein, D.·1994·Journal of Endocrinological Investigation
DOI 10.1007/bf03344959
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Abstract

The frequency, predisposing factors and course of agranulocytosis (granulocytes < 250/microliter) secondary to antithyroid drugs were studied in a cohort of 1256 continuously treated outpatients with hyperthyroidism during the 15 year period from 1973 to 1987. Two cases of agranulocytosis were detected; the frequency was 0.18% (95%-confidence intervals, 0.0-0.44%). This prevalence appears to be lower than reported in previous studies (up to 1.8%). For other adverse drug reactions, there was a clear-cut relationship to initial thionamide dose and to the body mass index; most reactions occurred during the first weeks of treatment. In addition, eight patients referred for thionamide drug- induced agranulocytosis were studied, and the following results obtained: Methimazole dose in patients with agranulocytosis was almost twice as in other patients (63.3 +/- 19.7 vs 34.3 +/- 29.7 mg daily) suggesting that this complication was related to dose. The interval between start of antithyroid drug treatment and first symptoms of agranulocytosis was 33 days (median; range, 23-55 days); hence, prolonged treatment beyond this period would appear relatively safe. Withdrawal of the causative agent and treatment of infection led to recovery of leukocyte counts within 15 days (median; range, 5-31 days). Two fatal outcomes were seen in referred patients. In one severely hyperthyroid patient with methimazole-induced agranulocytosis, recombinant human granulocyte/macrophage colony stimulating factor induced clinical and hematologic recovery within a few days of administration. In conclusion, agranulocytosis is the most severe side effect of antithyroid drugs. According to our results and a literature review, it occurs almost exclusively during the first ten weeks of treatment and is probably related to the drug dose.(ABSTRACT TRUNCATED AT 250 WORDS)

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Authors
Meyer-Geßner, M., Benker, G., Lederbogen, S., Olbricht, T., & Reinwein, D.
Affiliations
University of Duisburg-Essen (DE)
Venue
Journal of Endocrinological Investigation
Publisher
Springer Science and Business Media LLC
Published
1994-01
Volume
17
Issue
1
Pages
29-36
ISSN
  • 0391-4097 (ISSN-L)
  • 1720-8386
DOI
10.1007/bf03344959
OpenAlex
W2038624525
Cited by
88
References
37
Citations by year
2026: 2 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 2 · 2013: 2 · 2012: 3
FWCI
2.28
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of Endocrinological Investigation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Blood disorders and treatments
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Keywords
methimazole, thionamides, hyperthyroidism, adverse drug reactions, drug dosing, leukopenia, granulocyte colony-stimulating factor, body mass index
MeSH terms
Adult, Aged, Agranulocytosis, Dose-Response Relationship, Drug, Female, Germany, Humans, Hyperthyroidism, Leukocyte Count, Male, Methimazole, Middle Aged, Recombinant Proteins, Antithyroid Agents, Time Factors, Cohort Studies, Prevalence, Granulocyte-Macrophage Colony-Stimulating Factor

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