Document Detail


Successful treatment of thyroid storm with plasmapheresis in a patient with methimazole-induced agranulocytosis.
MedLine Citation:
PMID:  20439250     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report a case of a patient with Graves disease presenting with agranulocytosis induced by methimazole, with subsequent thyroid storm and successful therapeutic use of plasmapheresis.
METHODS: The clinical features and laboratory findings in a patient with agranulocytosis and thyroid storm are presented, and the available literature on utilization of plasmapheresis in the setting of thyrotoxicosis is reviewed.
RESULTS: A 40-year-old Vietnamese woman with Graves disease was admitted with methimazole-induced agranulocytosis. Treatment with methimazole was discontinued, and therapy with antibiotics, granulocyte colony-stimulating factor, and ibuprofen was initiated. During hospitalization of the patient, her clinical status deteriorated, with development of pericarditis, thrombocytopenia, and thyroid storm. Treatment with plasmapheresis yielded near-euthyroidism in 3 days. Subsequently, she underwent successful total thyroidectomy.
CONCLUSION: Our case highlights the effectiveness of plasmapheresis when clinical situations prohibit the use of traditional treatment methods for thyrotoxicosis or thyroid storm (or both).
Authors:
Ashish A Vyas; Priyanka Vyas; Nicole Lynn Fillipon; Rajakrishnan Vijayakrishnan; Nitin Trivedi
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  16     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-08-13     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  673-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Agranulocytosis / chemically induced,  complications*,  immunology
Antithyroid Agents / adverse effects*
Female
Graves Disease / complications,  drug therapy,  immunology
Humans
Methimazole / adverse effects*
Plasmapheresis*
Thyroid Crisis / complications*,  immunology,  surgery,  therapy*
Thyroidectomy
Thyrotoxicosis / immunology,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antithyroid Agents; 60-56-0/Methimazole

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


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