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首页> 外文期刊>International journal of endocrinology >Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature
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Unusual Synchronous Methimazole-Induced Agranulocytosis and Severe Hepatotoxicity in Patient with Hyperthyroidism: A Case Report and Review of the Literature

机译：甲亢患者异常同步甲基咪唑诱导的粒细胞缺乏和严重肝毒性：一例病例并文献复习

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Context. To report a patient with hyperthyroidism who developed concurrent occurrence of agranulocytosis and severe hepatotoxicity after taking methimazole (MMI).Case. A 51-year-old Chinese male was diagnosed as hyperthyroidism with normal white blood count and liver function. After 4 weeks’ treatment with MMI 20 mg/d, it developed to agranulocytosis and severe cholestatic hepatotoxicity. The patient’s symptoms and laboratory abnormalities disappeared after the withdrawal of MMI; his white blood count and liver function recover to normal in 2 weeks and 5 weeks, respectively. 296 MBq dose of131I was given to the patient 3 weeks after the withdrawal of MMI and his thyroid function was back to normal in 6 months. As we know through literature review, only 5 previous cases reported the synchronous ATD-induced agranulocytosis and severe hepatotoxicity in patients with hyperthyroidism.Methods. Review of the patient’s clinical course. Literature review of cases of hyperthyroidism with agranulocytosis and severe hepatotoxicity demonstrated that these complications occurred after taking antithyroid drug (ATD).Conclusions. Patient with hyperthyroidism can have synchronous ATD-induced agranulocytosis and severe hepatotoxicity. This case is extremely rare, but the adverse effects with ATDs is clinically significant. The clinicians need to be careful about this and monitor biochemical of patients who take ATDs.
机译：上下文。报告患有甲亢的患者在服用甲巯咪唑（MMI）后同时发生粒细胞缺乏症和严重的肝毒性。一名51岁的中国男性被诊断为甲状腺功能亢进症，白细胞计数和肝功能正常。 MMI20μmg/ d治疗4周后，发展为粒细胞缺乏症和严重的胆汁淤积性肝毒性。 MMI退出后，患者的症状和实验室异常消失;他的白血球计数和肝功能分别在2周和5周内恢复正常。 MMI停用3周后给予患者296MBq剂量的131I，其甲状腺功能在6个月内恢复正常。通过文献回顾我们知道，以前只有5例报告了甲亢患者同时发生ATD引起的粒细胞缺乏症和严重的肝毒性。回顾患者的临床过程。对甲状腺功能亢进症伴粒细胞缺乏症和严重肝毒性的文献回顾表明，这些并发症是在服用抗甲状腺药（ATD）后发生的。甲状腺功能亢进症患者可同时发生ATD诱导的粒细胞缺乏症和严重的肝毒性。这种情况极少发生，但ATD的不良反应在临床上很显着。临床医生需要对此谨慎，并监测服用ATD的患者的生化状况。

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