2026-04-17T03:50:30Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/105792025-10-24T10:22:47Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
García Gómez, Carlos
author
Navarro, Elena
author
Alcázar, Victoria
author
López-Guzmán, Antonio
author
Arrieta, Francisco
author
EMMA, ANDA
author
Biagetti, Betina
2025-10-24T10:22:47Z
2025-10-24T10:22:47Z
2023-11-09T09:07:50Z2023-11-09T09:07:50Z2023-10-16
http://hdl.handle.net/11351/10579
Agranulocitosis; Antitiroideos; CarbimazolAgranulocitosi; Antitiroïdals; CarbimazolAgranulocytosis; Antithyroid; CarbimazoleBackground: Antithyroid drug-induced agranulocytosis (AIA) (neutrophils <500/µL) 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.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Hipertiroïdisme - Tractament
Medicaments - Efectes secundaris
Agranulocitosi
DISEASES::Endocrine System Diseases::Thyroid Diseases::Hyperthyroidism
CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormone Antagonists::Antithyroid Agents
Other subheadings::Other subheadings::Other subheadings::/adverse effects
DISEASES::Hemic and Lymphatic Diseases::Hematologic Diseases::Leukocyte Disorders::Leukopenia::Agranulocytosis
Other subheadings::Other subheadings::Other subheadings::/chemically induced
ENFERMEDADES::enfermedades del sistema endocrino::enfermedades tiroideas::hipertiroidismo
COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::antagonistas de hormonas::antitiroideos
Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos
ENFERMEDADES::enfermedades hematológicas y linfáticas::enfermedades hematológicas::trastornos leucocitarios::leucopenia::agranulocitosis
Otros calificadores::Otros calificadores::Otros calificadores::/inducido químicamente
Therapeutic Management and Long-Term Outcome of Hyperthyroidism in Patients with Antithyroid-Induced Agranulocytosis: A Retrospective, Multicenter Study
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion