Characteristics of Antithyroid Drug–Induced Agranulocytosis in Patients with Hyperthyroidism: A Retrospective Analysis of 114 Cases in a Single Institution in China Involving 9690 Patients Referred for Radioiodine Treatment Over 15 Years
| Autor: | Zhen-Feng Liu, Jun Yang, Jun Zhang, Ji-Jun Zhong, Yang-Jun Zhu, Qin Xu, Meng-Jie Dong, Wan-Wen Weng |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male China medicine.medical_specialty Pediatrics Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Hyperthyroidism 03 medical and health sciences Methimazole 0302 clinical medicine Endocrinology Antithyroid Agents Granulocyte Colony-Stimulating Factor medicine Humans In patient 030212 general & internal medicine Single institution Retrospective Studies business.industry Antithyroid agent Retrospective cohort study Middle Aged Drug-induced agranulocytosis Surgery Granulocyte colony-stimulating factor Treatment Outcome Propylthiouracil Female business Agranulocytosis medicine.drug |
| Zdroj: | Thyroid. 26:627-633 |
| ISSN: | 1557-9077 1050-7256 |
| DOI: | 10.1089/thy.2015.0439 |
| Popis: | Antithyroid drug (ATD)-induced agranulocytosis is a rare but life-threatening disease. Clinical features of ATD-induced agranulocytosis and outcomes remain incompletely understood.Patients with clinically diagnosed ATD-induced agranulocytosis were retrospectively studied, involving 9690 patients who were referred for radioiodine treatment during a 15-year period (2000-2015) in China. There were 114 cases of agranulocytosis attributable to ATD included, and their clinical characteristics and therapy outcomes were analyzed.The female-to-male ratio of ATD-induced agranulocytosis was 10.4:1. The mean age (±standard deviation) of the patients with ATD-induced agranulocytosis was 41.7 ± 12.3 years. The methimazole and propylthiouracil doses given at the onset were 22.9 ± 8.0 mg/day and 253.6 ± 177.5 mg/day, respectively. ATD-induced agranulocytosis occurred in 45.1%, 74.3%, and 88.5% of patients within 4, 8, and 12 weeks of the onset of ATD therapy, respectively. Fever (78.9%) and sore throat (72.8%) were the most common symptoms when agranulocytosis was diagnosed. The mean recovery time of agranulocytosis was 13.41 ± 7.14 days. Recovery time in the granulocyte colony-stimulating factor (G-CSF)-treated group (12.7 ± 6.0 days) did not differ from that in the group not treated with G-CSF (16.4 ± 10.6 days; p = 0.144). Treatment with (131)I was successful in 87/98 patients (88.8%). The success rate of (131)I was equivalent (p = 1.000) between the groups receiving methimazole (88.2%, 75/85) and propylthiouracil (92.3%, 12/13).This largest single-institution study in China shows that ATD-induced agranulocytosis tends to occur within the first 12 weeks after the onset of ATD therapy. For patients with ATD-induced agranulocytosis, G-CSF does not improve the recovery time of agranulocytosis, and (131)I is an optimal treatment approach. |
| Databáze: | OpenAIRE |
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