Carregant...
Tipus de document
ArticleVersió
Versió publicadaData de publicació
Llicència de publicació
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/204380
Therapeutic Management and Long-Term Outcome of Hy-Perthyroidism in Patients with Antithyroid-Induced Agranu-Locytosis: A Retrospective, Multicenter Study
Títol de la revista
Director/Tutor
ISSN de la revista
Títol del volum
Recurs relacionat
Resum
Background: Antithyroid drug-induced agranulocytosis (AIA) (neutrophils <500/mu L) is a rare but serious complication in the treatment of hyperthyroidism. Methodology: Adult patients with AIA who were followed up at 12 hospitals in Spain were retrospectively studied. A total of 29 patients were studied. The etiology of hyperthyroidism was distributed as follows: Graves' disease (n = 21), amiodarone-induced thyrotoxicosis (n = 7), and hyperfunctioning multinodular goiter (n = 1). Twenty-one patients were treated with methimazole, as well as six patients with carbimazole and two patients with propylthiouracil. Results: The median (IQR) time to development of agranulocytosis was 6.0 (4.0-11.5) weeks. The most common presenting sign was fever accompanied by odynophagia. All of the patients required admission, reverse isolation, and broad-spectrum antibiotics; moreover, G-CSF was administered to 26 patients (89.7%). Twenty-one patients received definitive treatment, thirteen patients received surgery, nine patients received radioiodine, and one of the patients required both treatments. Spontaneous normalization of thyroid hormone values occurred in six patients (four patients with amiodarone-induced thyrotoxicosis and two patients with Graves' disease), and two patients died of septic shock secondary to AIA. Conclusions: AIA is a potentially lethal complication that usually appears around 6 weeks after the initiation of antithyroid therapy. Multiple drugs are required to control hyperthyroidism before definitive treatment; additionally, in a significant percentage of patients (mainly in those treated with amiodarone), hyperthyroidism resolved spontaneously.
Matèries
Matèries (anglès)
Citació
Citació
GARCÍA GÓMEZ, Carlos, NAVARRO, Elena, ALCÁZAR, Victoria, LÓPEZ GUZMÁN, Antonio, ARRIETA, Francisco, ANDA, Emma, BIAGETTI, Betina, GUERRERO PÉREZ, Fernando, VILLABONA ARTERO, Carlos, RUIZ DE ASSÍN VALVERDE, Andrés, LAMAS, Cristina, LECUMBERRI, Beatriz, ROSADO SIERRA, José antonio, SASTRE, Julia, DÍEZ, Juan josé, IGLESIAS, Pedro. Therapeutic Management and Long-Term Outcome of Hy-Perthyroidism in Patients with Antithyroid-Induced Agranu-Locytosis: A Retrospective, Multicenter Study. _Journal of Clinical Medicine_. 2023. Vol. 12, núm. 20. [consulta: 22 de gener de 2026]. ISSN: 2077-0383. [Disponible a: https://hdl.handle.net/2445/204380]