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( Ida Rose Dela Cruz ),( Kristine Denise Delos Reyes ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Case Presentation: Carbimazole is an antithyroid drug with a rare potentially fatal complication of agranulocytosis. Presented is a case of a 42-year-old male with Graves` disease and was admitted for fever. He initially presented with loose bowel movement, tremors, palpitation, and tachycardia and unexplained weight loss. He was maintained on Methimazole, but was later shifted to Carbimazole, when he developed rashes while taking the former drug. However, within a week of Carbimazole treatment, he developed fever, sore throat and agranulocytosis. Working diagnosis at that time was: Febrile neutropenia with acute tonsillopharyngitis, in Sepsis: Agranulocytosis secondary to Carbimazole: Graves` disease, in Thyroid Storm. Discussion: Carbimazole - induced agranulocytosis usually spontaneously resolves within one to two weeks of stopping the drug. The use of haemopoietic growth factors to stimulate the proliferation and differentiation of progenitor cells accelerates neutrophil recovery, as shown in this case. Conclusion: Agranulocytosis from carbimazole is an uncommon, life-threatening complication. With the potential to reduce morbidity and mortality, the use of haemopoietic growth factors certainly seems a justifiable option, instead of awaiting spontaneous recovery. Diagnosis and management of this case conveyed a dilemma that was resolved afterwards. Keywords: carbimazole, agranulocytosis, thyroid storm, haemopoietic growth factor, G-CSF
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