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Merck

Successful treatment of thyroid storm with plasmapheresis in a patient with methimazole-induced agranulocytosis.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (2010-05-05)
Ashish A Vyas, Priyanka Vyas, Nicole Lynn Fillipon, Rajakrishnan Vijayakrishnan, Nitin Trivedi
ABSTRAKT

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. 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. 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. Our case highlights the effectiveness of plasmapheresis when clinical situations prohibit the use of traditional treatment methods for thyrotoxicosis or thyroid storm (or both).

MATERIAŁY
Numer produktu
Marka
Opis produktu

Supelco
Methimazole, VETRANAL®, analytical standard
Sigma-Aldrich
2-Mercapto-1-methylimidazole, ≥99%
Supelco
Methimazole, analytical standard
Thiamazole, European Pharmacopoeia (EP) Reference Standard
USP
Methimazole, United States Pharmacopeia (USP) Reference Standard