Antithyroid Drug-Induced Hematopoietic Damage: A Retrospective Cohort Study of Agranulocytosis and Pancytopenia Involving 50,385 Patients with Graves' Disease
Abstract
CONTEXT: Although antithyroid drug (ATD)-induced hematopoietic damage is a significant concern, it has not been comprehensively investigated. OBJECTIVE: Our objective was to describe the clinical features of ATD-induced hematopoietic damage. DESIGN AND SETTING: This was a retrospective cohort study in Tokyo, Japan. PATIENTS: Between January 1983 and December 2002, 50,385 patients at Ito Hospital were diagnosed with Graves' disease. We retrospectively reviewed their medical, pathological, and laboratory records between January 1983 and December 2010. MAIN OUTCOME: Incidence and clinical features of ATD-induced agranulocytosis and pancytopenia were evaluated. RESULTS: Of 55 patients with documented hematopoietic damage, 50 had agranulocytosis and 5 had pancytopenia. All of them received ATD, either methimazole (n = 51) or propylthiouracil (n = 4). Median intervals between initiation of ATD therapy and the onset of agranulocytosis and pancytopenia were 69 d (range, 11-233 d) and 41 d (range, 32-97 d), respectively. Either anemia or thrombocytopenia was also documented in seven of the 50 patients with agranulocytosis. Agranulocytosis was the first manifestation of hematopoietic damage in four of the five patents with pancytopenia. Hematopoietic damage recovered with supportive measures including granulocyte colony-stimulating factor (n = 37), steroids (n = 10), and other supportive measures (n = 8) in 54 patients, whereas the remaining patient died of complications from infection. This study failed to identify the risk factors for ATD-induced hematopoietic damage. CONCLUSIONS: This study showed that ATD cause hematopoietic changes, which are occasionally severe and potentially fatal. The pathogenesis of agranulocytosis and pancytopenia might overlap, and additional studies are warranted to clarify this and to establish an optimal treatment strategy.
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Three recent reports of large numbers of ATD-treated patients who developed hematologic complications provide information on risk factors, treatment, and outcomes.
“Three recent reports of large numbers of ATD-treated patients who developed hematologic complications provide information on risk factors, treatment, and outcomes (127-129).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [127]
Two of the three recent reports were from Japan and one from Denmark; in both countries the majority of patients are treated with MMI, so data are more limited for PTU-associated agranulocytosis.
“Two studies were from Japan and one was from Denmark.In both countries the majority of patients are treated with MMI, so data are more limited for PTU-associated agranulocytosis.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [127]
No predictive risk factors for the development of agranulocytosis could be identified.
“No predictive risk factors for the development of agranulocytosis could be identified.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [127]
In the first study, a retrospective cohort analysis of over 50,000 Graves' disease patients found 55 developed agranulocytosis, of whom five had pancytopenia, for an estimated cumulative incidence of 0.3% in 100 days, with a median interval to onset of 69 days.
“In the first study, a retrospective cohort analysis of over 50,000 GD patients, 55 developed agranulocytosis, of whom five had pancytopenia, for an estimated cumulative incidence of 0.3% in 100 days (127), with a median interval to onset of 69 days.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [127]
All 50 patients with agranulocytosis alone were successfully treated with granulocyte colony stimulating factor, steroids, or supportive care, but one of five patients with pancytopenia died.
“All 50 patients with agranulocytosis alone were successfully treated with granulocyte colony stimulating factor, steroids, or supportive care, but one of five patients with pancytopenia died.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [127]
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Cites
DeGroot, L. J., Abalovich, M., Alexander, E. K., Amino, N., Barbour, L. A., Cobin, R. H., Eastman, C. J., Lazarus, J. H., Luton, D., Mandel, S. J., et al. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2803 · Cited by 1,862 · see citing works
Abalovich, M., Amino, N., Barbour, L. A., Cobin, R. H., DeGroot, L. J., Glinoer, D., Mandel, S. J., & Stagnaro‐Green, A. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0141 · Cited by 929 · see citing works
Spontaneous reporting of adverse reactions to carbimazole and propylthiouracil in the UK
Pearce, S. H. S. (2004) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.02135.x · Cited by 120 · see citing works
Fibbe, W. E., Claas, F. H. J., van der Star, W., Meyboom, R. H. B., Meyboom, R. H. B., & Falkenburg, J. H. F. (1986) · British Journal of Haematology · doi:10.1111/j.1365-2141.1986.tb04130.x · Cited by 100 · see citing works
Thyroid function in wholly breast‐feeding infants whose mothers take high doses of propylthiouracil
Momotani, N., Yamashita, R., Makino, F., Noh, J. Y., Ishikawa, N., Ito, K., & Ito, K. (2000) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2000.01078.x · Cited by 94 · see citing works
Self-citationHaematopoietic growth factor in antithyroid-drug-induced agranulocytosis
Andrès, E. (2001) · QJM · doi:10.1093/qjmed/94.8.423 · Cited by 73 · see citing works
Akamizu, T., Ozaki, S., Hiratani, H., Uesugi, H., Sobajima, J., Hataya, Y., Kanamoto, N., Saijo, M., Hattori, Y., Moriyama, K., et al. (2002) · Clinical & Experimental Immunology · doi:10.1046/j.1365-2249.2002.01720.x · Cited by 58 · see citing works
Michallet, M., Sobh, M., Morisset, S., Kraghel, S., Nicolini, F. E., Thomas, X., Bienvenu, A., Picot, S., Nicolle, M., & Vanhems, P. (2011) · Medical Mycology · doi:10.3109/13693786.2011.557668 · Cited by 49 · see citing works
Aplastic Anemia Associated with Antithyroid Drugs
Biswas, N., Ahn, Y.-H., Goldman, J. M., & Schwartz, J. M. (1991) · The American Journal of the Medical Sciences · doi:10.1097/00000441-199103000-00008 · Cited by 42 · see citing works
Escobar-Morreale, H. F., BRAVO, P., García‐Robles, R., García‐Laraña, J., de la Calle, H., & SANCHO, J. M. (1997) · Thyroid · doi:10.1089/thy.1997.7.67 · Cited by 32 · see citing works
Moreb, J. S., Shemesh, O., Shilo, S., Manor, C., & Hershko, C. (2009) · Acta Haematologica · doi:10.1159/000206873 · Cited by 31 · see citing works
Douer, D., & Eisenstein, Z. (1988) · European Journal Of Haematology · doi:10.1111/j.1600-0609.1988.tb00803.x · Cited by 30 · see citing works
Mezquita, P., LUNA, V., Muñoz‐Torres, M., Torres-Vela, E. M., LOPEZ-RODRIGUEZ, F., Callejas-Rubio, J. L., & Escobar‐Jiménez, F. (1998) · Thyroid · doi:10.1089/thy.1998.8.791 · Cited by 29 · see citing works
Methimazole-Induced Aplastic Anemia Caused by Hypocellular Bone Marrow with Plasmacytosis
YAMAMOTO, A., Katayama, Y., Tomiyama, K., Hosoai, H., Hirata, F., Kimura, F., Fujita, K., & Yasuda, H. (2004) · Thyroid · doi:10.1089/105072504773297911 · Cited by 25 · see citing works
APLASTIC ANEMIA DURING THE TREATMENT OF HYPERTHYROIDISM WITH TAPAZOLE
LEVINE, B., & ROSENBERG, D. V. (1954) · Annals of Internal Medicine · doi:10.7326/0003-4819-41-4-844 · Cited by 19 · see citing works
Fatal Case of Marrow Aplasia after Treatment with Carbimazole
Richardson, J. S., Sárkány, I., & Campbell, C. D. (1954) · BMJ · doi:10.1136/bmj.1.4858.364 · Cited by 14 · see citing works
López‐Karpovitch, X., Ulloa‐Aguirre, A., von Eiff, C., Hurtado-Monroy, R., & Alanis, A. J. (2009) · Acta Haematologica · doi:10.1159/000204742 · Cited by 12 · see citing works
Jakucs, J., & Pocsay, G. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03349180 · Cited by 8 · see citing works
Recovery From Carbimazole- Induced Aplastic Anemia
Wilcox, G., Wong, R., Elliott, P., DuncanJ, T., & Stockigt, J. R. (2003) · Intern J Endocrinol Metab · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Solomon DH 1986 Treatment of Graves' hyperthyroidism. In: In- gbar SH, Braverman LE, eds. Werner's the thyroid. 5th ed. Phila- delphia: JB Lippincott; 987-1014
Cited by
Sorted by citations
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
“3% in 100 days (127), with a median interval to onset of 69 days.”
BackgroundStagnaro-Green, A., Abalovich, M., Alexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E. N., Soldin, O. P., Sullivan, S., et al. (2011) · Thyroid · doi:10.1089/thy.2011.0087 · Cited by 2,942 · see citing works
Alexander, E. K., Pearce, E. N., Brent, G. A., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., et al. (2017) · Thyroid® · doi:10.1089/thy.2016.0457 · Cited by 2,731 · see citing works
2018 European Thyroid Association Guideline for the Management of Graves’ Hyperthyroidism
Kahaly, G. J., Bartalena, L., Hegedüs, L., Leenhardt, L., Poppe, K. G., & Pearce, S. H. S. (2018) · European Thyroid Journal · doi:10.1159/000490384 · Cited by 982 · see citing works
De Leo, S., Lee, S. Y., & Braverman, L. E. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00278-6 · Cited by 883 · see citing works
Davies, T. F., Andersen, S., Latif, R., Nagayama, Y., Barbesino, G., Brito, M., Eckstein, A. K., Stagnaro‐Green, A., & Kahaly, G. J. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0184-y · Cited by 421 · see citing works
Bonnema, S. J., & Hegedűs, L. D. (2012) · Endocrine Reviews · doi:10.1210/er.2012-1030 · Cited by 338 · see citing works
Long-Term Antithyroid Drug Treatment: A Systematic Review and Meta-Analysis
Azizi, F., & Malboosbaf, R. (2017) · Thyroid · doi:10.1089/thy.2016.0652 · Cited by 114 · see citing works
Antithyroid Drug Side Effects in the Population and in Pregnancy
Andersen, S. L., Olsen, J., & Laurberg, P. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-4274 · Cited by 107 · see citing works
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management
Trohman, R. G., Sharma, P. S., McAninch, E. A., & Bianco, A. C. (2018) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2018.09.005 · Cited by 107 · see citing works
Villagelin, D., Romaldini, J. H., dos Santos, R. B., Milkos, A. B. B. P., & Ward, L. S. (2015) · Thyroid · doi:10.1089/thy.2015.0195 · Cited by 98 · see citing works
Sundaresh, V., Brito, J. P., Thapa, P., Bahn, R. S., & Stan, M. N. (2017) · Thyroid · doi:10.1089/thy.2016.0343 · Cited by 91 · see citing works
Diagnosis and management of thyrotoxicosis
Vaidya, B., & Pearce, S. H. S. (2014) · BMJ · doi:10.1136/bmj.g5128 · Cited by 90 · see citing works
Graves’ hyperthyroidism in pregnancy: a clinical review
Nguyen, C. T., Sasso, E. B., Barton, L., & Mestman, J. H. (2018) · Clinical Diabetes and Endocrinology · doi:10.1186/s40842-018-0054-7 · Cited by 94 · see citing works
Gessl, A., Lemmens‐Gruber, R., & Kautzky‐Willer, A. (2012) · Handbook of experimental pharmacology · doi:10.1007/978-3-642-30726-3_17 · Cited by 77 · see citing works
Bartalena, L., Chiovato, L., & Vitti, P. (2016) · Journal of Endocrinological Investigation · doi:10.1007/s40618-016-0505-x · Cited by 75 · see citing works
Safety of long-term antithyroid drug treatment? A systematic review
Azizi, F., & Malboosbaf, R. (2019) · Journal of Endocrinological Investigation · doi:10.1007/s40618-019-01054-1 · Cited by 64 · see citing works
Hyperthyroidism and Thyrotoxicosis
Fatourechi, V. (2013) · Springer eBooks · doi:10.1007/978-1-4614-8684-8_2 · Cited by 54 · see citing works
Yang, J. J., Zhu, Y., Zhong, J., Zhang, J., Weng, W.-W., Liu, Z.-F., Xu, Q., & Dong, M. (2016) · Thyroid · doi:10.1089/thy.2015.0439 · Cited by 53 · see citing works
Carlé, A., Andersen, S. L., Boelaert, K., & Laurberg, P. (2017) · European Journal of Endocrinology · doi:10.1530/eje-16-0276 · Cited by 48 · see citing works
Lacotte, P., Buisson, D., & Ambroise, Y. (2013) · European Journal of Medicinal Chemistry · doi:10.1016/j.ejmech.2013.01.043 · Cited by 47 · see citing works
Suzuki, N., Noh, J. Y., Hiruma, M., Kawaguchi, A., Morisaki, M., Ohye, H., Suzuki, M., Matsumoto, M., Kunii, Y., Iwaku, K., et al. (2019) · Thyroid · doi:10.1089/thy.2019.0045 · Cited by 47 · see citing works
Self-citationKobayashi, S., Noh, J. Y., Mukasa, K., Kunii, Y., Watanabe, N., Matsumoto, M., Ohye, H., Suzuki, M., Yoshihara, A., Iwaku, K., et al. (2014) · Thyroid® · doi:10.1089/thy.2013.0476 · Cited by 45 · see citing works
Self-citationKawkgi, O. M. E., Ross, D. S., & Stan, M. N. (2020) · Clinical Endocrinology · doi:10.1111/cen.14374 · Cited by 42 · see citing works
Amiodarone Therapy: Updated Practical Insights
Șorodoc, V., Indrei, L., Dobroghii, C., Asaftei, A., Ceasovschih, A., Constantin, M., Lionte, C., Morărașu, B. C., Diaconu, A.-D., & Șorodoc, L. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13206094 · Cited by 38 · see citing works
Neutropenia in patients with hyperthyroidism: Systematic review and meta‐analysis
Scappaticcio, L., Maiorino, M. I., Maio, A., Esposito, K., & Bellastella, G. (2020) · Clinical Endocrinology · doi:10.1111/cen.14313 · Cited by 34 · see citing works
Vaidya, B., Wright, A., Shuttleworth, J., Donohoe, M. E., Warren, R. E., Brooke, A. M., Gericke, C. A., & Ukoumunne, O. C. (2014) · Clinical Endocrinology · doi:10.1111/cen.12478 · Cited by 34 · see citing works
Yang, J. J., Yao, L., Dong, M., Xu, Q., Zhang, J., Weng, W.-W., & Chen, F. (2017) · Thyroid · doi:10.1089/thy.2017.0468 · Cited by 31 · see citing works
Yang, J., Zhong, J., Xiao, X., Zhou, L., Chen, Y., Liu, J., Cao, R.-X., & Wen, G. (2012) · Endocrine Journal · doi:10.1507/endocrj.ej12-0332 · Cited by 27 · see citing works
He, Y., Zheng, J., Zhang, Q., Hou, P., Zhu, F., Yang, J., Li, W., Chen, P., Liu, S., Zhang, B., et al. (2017) · Scientific Reports · doi:10.1038/s41598-017-12350-2 · Cited by 26 · see citing works
Hsieh, C.-H., Shueng, P., Lin, S.-C., Tien, H., Shiau, A., Chou, Y., Wu, M., Wang, J., Chen, C., & Chen, Y.-J. (2013) · BioMed Research International · doi:10.1155/2013/717589 · Cited by 22 · see citing works
Noh, J. Y., Inoue, K., Suzuki, N., Yoshihara, A., Fukushita, M., Matsumoto, M., Imai, H., Hiruma, S., Ichikawa, M., Koshibu, M., et al. (2024) · Endocrine Journal · doi:10.1507/endocrj.ej24-0135 · Cited by 22 · see citing works
Self-citationBarwinek, K., Gąsior‐Perczak, D., Trepka, S., Szczodry, A., Kopczyński, J., Sitarz-Żelazna, Z., & Kowalska, A. (2020) · Medicina · doi:10.3390/medicina56060290 · Cited by 18 · see citing works
Graves’ hyperthyroidism-related pancytopenia: a case report with literature review
Scappaticcio, L., Bellastella, G., Maiorino, M. I., Longo, M., Catalano, C., Esposito, K., Paolisso, G., & Rizzo, M. R. (2020) · HORMONES · doi:10.1007/s42000-020-00227-5 · Cited by 17 · see citing works
Okamura, K., Sato, K., Fujikawa, M., Bandai, S., Ikenoue, H., & Kitazono, T. (2022) · Endocrine Journal · doi:10.1507/endocrj.ej21-0436 · Cited by 17 · see citing works
Atypical Complications of Graves’ Disease: A Case Report and Literature Review
Baagar, K. A. M., Siddique, M. A., Arroub, S. A., Ebrahim, A., & Jayyousi, A. (2017) · Case Reports in Endocrinology · doi:10.1155/2017/6087135 · Cited by 16 · see citing works
Cattoni, A., Molinari, S., Riva, B., Marco, S. D., Adavastro, M., Faraguna, M. C., Garella, V., Medici, F., Nicolosi, M. L., Pellegrinelli, C., et al. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1064146 · Cited by 16 · see citing works
Lithium Carbonate in the Treatment of Graves’ Disease with ATD-Induced Hepatic Injury or Leukopenia
Zheng, R., Liu, K., Chen, K., Cao, W., Cao, L., Zhang, H., Sun, H., & Liu, C. (2015) · International Journal of Endocrinology · doi:10.1155/2015/694023 · Cited by 15 · see citing works
Frequency of Adverse Events of Antithyroid Drugs Administered during Pregnancy
Yoshihara, A., Noh, J. Y., Watanabe, N., Iwaku, K., Kobayashi, S., Suzuki, M., Ohye, H., Matsumoto, M., Kunii, Y., Mukasa, K., et al. (2014) · Journal of Thyroid Research · doi:10.1155/2014/952352 · Cited by 15 · see citing works
Self-citationNakamura, H., Ide, A., Kudo, T., Nishihara, E., Ito, M., & Miyauchi, A. (2016) · European Thyroid Journal · doi:10.1159/000448586 · Cited by 15 · see citing works
Gershinsky, M., Saliba, W., Lavi, I., Shapira, C., & Gronich, N. (2019) · Thyroid · doi:10.1089/thy.2018.0274 · Cited by 15 · see citing works
Yang, J. J., Zhang, J., Xu, Q., Sheng, G.-P., Weng, W.-W., & Dong, M. (2015) · International Journal of Endocrinology · doi:10.1155/2015/934726 · Cited by 15 · see citing works
Life‐Threatening Thyrotoxicosis
Warnock, A., Cooper, D. S., & Burch, H. B. (2018) · Wiley eBooks · doi:10.1002/9781119374800.ch16 · Cited by 13 · see citing works
Wang, Y., Li, X., Yang, Q., Wang, W., Zhang, Y., Liu, J., Zheng, L., & Zha, B. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00789 · Cited by 13 · see citing works
Application of oral inorganic iodine in the treatment of Graves’ disease
Huang, Y., Xu, Y., Xu, M., Zhao, X., & Chen, M. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1150036 · Cited by 12 · see citing works
Tizianel, I., Sabbadin, C., Censi, S., Clausi, C., Colpo, A., Leahu, A. I., Iacobone, M., Mian, C., Scaroni, C. M., & Ceccato, F. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13030517 · Cited by 10 · see citing works
He, Y., Li, J., Zheng, J., Khan, Z., Qiang, W., Gao, F., Zhao, Y., & Shi, B. (2017) · Journal of Endocrinological Investigation · doi:10.1007/s40618-017-0626-x · Cited by 10 · see citing works
Diagnosis and Management of Fetal and Neonatal Thyrotoxicosis
Bohîlțea, R. E., Mihai, B.-M., Szini, E., Șucaliuc, I.-A., & Badiu, C. (2022) · Medicina · doi:10.3390/medicina59010036 · Cited by 11 · see citing works
Marrow hypoplasia: a rare complication of untreated Grave’s disease
Garcia, J., de França, L., Ellinger, V., & Wolff, M. (2014) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/0004-2730000003216 · Cited by 10 · see citing works
Thyroid Hormones, Iodine and Iodides, and Antithyroid Drugs
Mody, V. V., Singh, A. N., Deshmukh, R. R., & Shah, S. (2015) · Side effects of drugs annual · doi:10.1016/bs.seda.2015.08.007 · Cited by 10 · see citing works
Clinical characteristics of antithyroid drug-induced aplastic anemia cases over the past 30 years
Cheng, Y., Xia, X.-Y., Zhang, W., Ren, L., Tian, C.-F., Liu, D., & Xue, G. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1064723 · Cited by 10 · see citing works
Dai, Y., Wu, X., Yin, Y., & Dai, H. (2022) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2022.121600 · Cited by 9 · see citing works
Herbal approach in the treatment of pancytopenia
Parab, S. B., Kale, P. P., Bhatt, L. K., & Prabhavalkar, K. S. (2017) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2016-0053 · Cited by 9 · see citing works
Chang, Y., Tseng, C., & Yuan, K. (2017) · Clinical Advances in Periodontics · doi:10.1902/cap.2017.170015 · Cited by 9 · see citing works
Kim, H., Lee, J., & Ha, J. (2018) · Clinical Case Reports · doi:10.1002/ccr3.1644 · Cited by 8 · see citing works
The evolving therapeutic landscape of Graves’ disease in adults: present and future
Stan, M. N., & Dosiou, C. (2025) · European Thyroid Journal · doi:10.1530/etj-25-0078 · Cited by 8 · see citing works
Andrès, E., Villalba, N. L., Mourot-Cottet, R., Maloisel, F., Tebacher, M., Gottenberg, J., Goichot, B., Herbrecht, R., & Zulfiqar, A. (2020) · Medicines · doi:10.3390/medicines7030015 · Cited by 8 · see citing works
Hiruma, M., Sasano, Y., Watanabe, N., Yoshihara, A., Ishii, S., Yaguchi, Y., Noh, J. Y., Sugino, K., & Ito, K. (2020) · Endocrine Journal · doi:10.1507/endocrj.ej20-0184 · Cited by 8 · see citing works
Self-citationThyroid Disorders in Children and Adolescents
Rivkees, S. A., & Bauer, A. J. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-62520-3.00013-0 · Cited by 9 · see citing works
Antithyroid drug-induced leukopenia and G-CSF administration: a long-term cohort study
Kamitani, F., Nishioka, Y., Koizumi, M., Nakajima, H., Kurematsu, Y., Okada, S., Kubo, S., Myojin, T., Noda, T., Imamura, T., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-46307-5 · Cited by 8 · see citing works
Okamura, K., Bandai, S., Fujikawa, M., Sato, K., & Kitazono, T. (2020) · Endocrine Journal · doi:10.1507/endocrj.ej20-0016 · Cited by 8 · see citing works
Antithyroid drug induced agranulocytosis: what still we need to learn ?
Chaudhry, L. A., Mazen, K. F., Ba-Essa, E. M., & Robert, A. A. (2016) · Pan African Medical Journal · doi:10.11604/pamj.2016.23.27.8365 · Cited by 8 · see citing works
A report of three cases of untreated Graves' disease associated with pancytopenia in Malaysia.
Rafhati, A. N., See, C. K., Hoo, F. K., & Badrulnizam, L. B. M. (2014) · PubMed Central · doi:10.14661/2014.877-882 · Cited by 8 · see citing works
Arai, M., Tsuno, T., Konishi, H., Nishiyama, K., Terauchi, Y., Inoue, R., & Shirakawa, J. (2023) · Thyroid · doi:10.1089/thy.2023.0030 · Cited by 7 · see citing works
Watanabe, N. (2024) · Endocrine Journal · doi:10.1507/endocrj.ej24-0186 · Cited by 7 · see citing works
Self-citationHerbal Medicines for Thyroid Diseases
Singh, B., Sundar, S., & Shukla, A. (2020) · Advances in medical diagnosis, treatment, and care (AMDTC) book series · doi:10.4018/978-1-7998-4808-0.ch011 · Cited by 7 · see citing works
Fadeev, V. V. (2020) · Clinical and experimental thyroidology · doi:10.14341/ket12474 · Cited by 8 · see citing works
Conversion of Primary Hypothyroidism to Hyperthyroidism: A Case Report
Clifford, L. M., & Wakil, A. (2018) · Journal of the ASEAN Federation of Endocrine Societies · doi:10.15605/jafes.033.02.12 · Cited by 7 · see citing works
Miyamura, K., Ito, M., Yamaoka, H., Hisakado, M., Nishihara, E., Fukata, S., Nishikawa, M., Miyauchi, A., & Akamizu, T. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf433 · Cited by 6 · see citing works
Tratamiento del hipertiroidismo por Enfermedad de Graves en pacientes adultos no embarazadas
Ana Fadel, A., Gutiérrez, S., Novelli, J. L., Orlandi, A. M., Parma, R., Croome, M. D. C. S., Chebel, G., Guardia, M., Guido, P., Gilligan, M., et al. (2013) · Revista Argentina de Endocrinología y Metabolismo · Cited by 6 · see citing works
Orgiazzi, J. (2015) · Clinical Thyroidology · doi:10.1089/ct.2015;27.302-305 · Cited by 6 · see citing works
Carbimazole-induced pancytopaenia
Psomadakis, C., Creamer, A. W., & Baynes, C. (2016) · British Journal of Hospital Medicine · doi:10.12968/hmed.2016.77.4.248 · Cited by 6 · see citing works
Gómez, C. G., Navarro, E., Alcázar, V., López-Guzmán, A., Arrieta, F., Anda, E., Biagetti, B., Guerrero‐Pérez, F., Villabona, C. M., Valverde, A. R. D. A., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12206556 · Cited by 6 · see citing works
Zoledronic acid–induced severe lymphopenia
Karpuz, S. (2023) · Osteoporosis International · doi:10.1007/s00198-023-06831-6 · Cited by 5 · see citing works
Pre-treatment Neutropenia in Children and Adolescents with Autoimmune Hyperthyroidism
Litao, M. K. S., Alvarez, A. G., & Shah, B. C. (2020) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.galenos.2020.2020.0184 · Cited by 5 · see citing works
Munir, F., Javaid, H. W., Rana, M. B. M., & Shaukat, F. (2022) · Cureus · doi:10.7759/cureus.23226 · Cited by 5 · see citing works
Life-Threatening Thyrotoxicosis: Thyroid Storm and Adverse Effects of Antithyroid Drugs
Warnock, A., Cooper, D. S., & Burch, H. B. (2014) · The Endocrine Society eBooks · doi:10.1210/eme.9781936704811.ch11 · Cited by 5 · see citing works
Antithyroid drugs and the dose–risk balance: a meta-analysis on agranulocytosis in hyperthyroidism
Stieben, L. A. R., Brun, L. R., Doddi, P. N., & Brance, M. L. (2025) · Endocrine · doi:10.1007/s12020-025-04372-y · Cited by 4 · see citing works
Tseng, C., Tseng, C., Chen, H.-S., Chen, P., & Huang, C.-J. (2023) · Journal of the Chinese Medical Association · doi:10.1097/jcma.0000000000000966 · Cited by 4 · see citing works
Caglar, S. E., Karakoç, Y., Tanoğlu, A., Demirtunç, R., Tanrıkulu, S., Kilickaya, H., & Ercan, M. (2025) · Thyroid Research · doi:10.1186/s13044-025-00227-w · Cited by 4 · see citing works
Pancytopenia in a Patient with Grave's Disease.
Loh, H. H., & Tan, F. H. S. (2013) · PubMed · Cited by 4 · see citing works
Gong, X., Chen, P., Ma, P., Gao, J., Yang, J., Guo, H., Yan, C., Zhang, B., & He, Y. (2020) · Immunity Inflammation and Disease · doi:10.1002/iid3.359 · Cited by 4 · see citing works
Thyroid hormones, iodine and iodides, and antithyroid drugs
Ling, H., Patel, A., Park, J., & Bhave, V. (2019) · Side effects of drugs annual · doi:10.1016/bs.seda.2019.07.019 · Cited by 4 · see citing works
So erkennen und behandeln Sie die Hyperthyreose
Schmidt, M. C. (2017) · CME · doi:10.1007/s11298-017-5982-5 · Cited by 4 · see citing works
Kim, K. J., Song, E., Kim, M., Kwon, H., Ku, E. J., Kwon, H. W., Yoon, J. H., Lee, E. K., Lee, W. W., Park, Y. J., et al. (2025) · Endocrinology and Metabolism · doi:10.3803/enm.2025.2464 · Cited by 3 · see citing works
Thyroid hormones, iodine and iodides, and antithyroid drugs
Gales, L., & Aronson, J. K. (2014) · Side effects of drugs annual · doi:10.1016/b978-0-444-62635-6.00041-3 · Cited by 3 · see citing works
Xing, H., & Guan, X. (2014) · Oral Surgery Oral Medicine Oral Pathology and Oral Radiology · doi:10.1016/j.oooo.2014.11.001 · Cited by 3 · see citing works
Buldygina, Y. V., Strafun, L. S., Terekhova, H. М., Shlyakhtych, S. L., & Pankiv, V. І. (2019) · INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) · doi:10.22141/2224-0721.15.2.2019.166111 · Cited by 3 · see citing works
Selim, S., Pathan, M. F., Rahman, M., Saifuddin, M., Qureshi, N. K., Mir, A. S., Afsana, F., Haq, T., Kamrul-Hasan, A. B. M., & Ashrafuzzaman, S. (2023) · Bangladesh Journal of Endocrinology and Metabolism · doi:10.4103/bjem.bjem_2_23 · Cited by 3 · see citing works
Okamura, K. (2024) · Endocrinology and Metabolism · doi:10.3803/enm.2024.2079 · Cited by 3 · see citing works
Tratamiento de la enfermedad de Graves Basedow
Vargas‐Uricoechea, H., Sierra-Torres, C. H., & Meza-Cabrera, I. A. (2014) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 3 · see citing works
Thyroid hormones, Iodine and Iodides, and Antithyroid Drugs
Deshmukh, R. R., Singh, A. N., Martinez, M., Gandhi, N., Cotta, K. I., Parihar, H. S., & Mody, V. V. (2016) · Side effects of drugs annual · doi:10.1016/bs.seda.2016.08.026 · Cited by 3 · see citing works
Association of MICA gene polymorphisms with thionamide-induced agranulocytosis
Ma, P., Chen, P., Gao, J., Guo, H., Li, S., Yang, J., Lai, J., Yang, X., Zhang, B., & He, Y. (2020) · Journal of Endocrinological Investigation · doi:10.1007/s40618-020-01319-0 · Cited by 3 · see citing works
Risk mitigation with the use of clozapine - Quo vadimus
Suhas, S., Jolly, A. J., Nayok, S. B., Sreeraj, V. S., Kumar, V., Rao, N. P., & Venkatasubramanian, G. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102693 · Cited by 3 · see citing works
Thyroid Hormones, Iodine and Iodides, and Antithyroid Drugs
Bhave, V., Patel, A., Deshmukh, R. R., Singh, A. N., & Mody, V. V. (2018) · Side effects of drugs annual · doi:10.1016/bs.seda.2018.08.011 · Cited by 3 · see citing works
Schempp, V., Cebeci, A. N., Reinauer, C., Woelfle, J., Dörr, H., Roosen, M.-T., Gohlke, J., & Gohlke, B. C. (2024) · Thyroid · doi:10.1089/thy.2023.0673 · Cited by 2 · see citing works
Graves’ Disease: What Is the Role and Timing of Surgery?
Elfenbein, D. M., & Sippel, R. S. (2015) · Springer eBooks · doi:10.1007/978-3-319-20523-6_8 · Cited by 2 · see citing works
Atypical Clinical Courses of Graves' Disease Confound Differential Diagnosis of Hyperthyroidism
Yamaguchi, Y., Okajima, F., Sugihara, H., Iwabu, M., & Emoto, N. (2023) · Journal of Nippon Medical School · doi:10.1272/jnms.jnms.2024_91-104 · Cited by 2 · see citing works
Association Between HLA-DRB1 Alleles and Gravesʼ Disease in Asian Populations: A Meta-Analysis
Li, W., Ke, T., Wang, J., Zhu, F., & Chi, Y. (2024) · Hormone and Metabolic Research · doi:10.1055/a-2298-4366 · Cited by 2 · see citing works
Carbimazole-induced acute myeloid leukemia: A very rare case report and review of the literature
Mittal, L., & Jasuja, S. K. (2025) · Indian Journal of Cancer · doi:10.4103/ijc.ijc_366_21 · Cited by 2 · see citing works
- Authors
- Watanabe, N., Narimatsu, H., Noh, J. Y., Yamaguchi, T., Kobayashi, K., Kami, M., Kunii, Y., Mukasa, K., Ito, K., & Ito, K.
- Affiliations
- Ito Hospital (JP)
- Yamagata University (JP)
- Tohoku University (JP)
- JR Tokyo General Hospital (JP)
- Institute of Medical Science, The University of Tokyo (JP)
- Corresponding author
- Noh, Jaeduk Yoshimura
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-01
- Volume
- 97
- Issue
- 1
- Pages
- E49-E53
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2143907782
- Cited by
- 167
- References
- 19
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 11 · 2023: 12 · 2022: 15 · 2021: 12 · 2020: 21 · 2019: 8 · 2018: 11 · 2017: 14 · 2016: 11 · 2015: 9 · 2014: 10 · 2013: 9 · 2012: 4
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Blood disorders and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Emergency Medicine › Hematological disorders and diagnostics
- Keywords
- antithyroid drugs, agranulocytosis, pancytopenia, hematopoietic damage, Graves' disease, methimazole, propylthiouracil, drug-induced neutropenia, granulocyte colony-stimulating factor, infectious complications, risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Agranulocytosis, Child, Female, Graves Disease, Hematopoiesis, Humans, Japan, Male, Methimazole, Middle Aged, Pancytopenia, Propylthiouracil, Retrospective Studies, Antithyroid Agents, Tokyo, Cohort Studies, Young Adult
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