Document Detail


Propylthiouracil-induced agranulocytosis in the third trimester of pregnancy.
MedLine Citation:
PMID:  20664427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thionamide-induced agranulocytosis in pregnancy is a rare event that poses unique therapeutic challenges. CASE: A 37-year-old woman developed agranulocytosis while taking propylthiouracil in the third trimester. After she took broad-spectrum antibiotics and discontinued propylthiouracil, her neutrophil counts recovered. She was initially managed expectantly but later underwent an uncomplicated total thyroidectomy at 35 weeks of gestation because of patient choice coupled with worsening thyrotoxicosis. CONCLUSION: In circumstances in which thionamides are contraindicated, management options of hyperthyroidism in pregnancy are limited. The proximity to term in the third trimester makes expectant management an attractive approach when maternal thyroid indices are stable, allowing for a choice of postpartum therapies without the worry of fetal implications. However, this strategy carries risks, and thyroidectomy in the third trimester can be a safe alternative.
Authors:
Ally Murji; Mara L Sobel; Denice S Feig; Mathew Sermer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  116 Suppl 2     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  485-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Agranulocytosis / chemically induced*,  therapy
Antithyroid Agents / adverse effects*
Female
Graves Disease / drug therapy*,  surgery
Humans
Pregnancy
Pregnancy Complications, Hematologic / chemically induced*
Pregnancy Trimester, Third
Propylthiouracil / adverse effects*
Thyroidectomy
Chemical
Reg. No./Substance:
0/Antithyroid Agents; 51-52-5/Propylthiouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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