Thyroid Research and Practice

CASE REPORT
Year
: 2009  |  Volume : 6  |  Issue : 3  |  Page : 84--87

Granulocyte colony stimulating factor in the treatment anti-thyroid drug induced agranulocytosis


MP Baruah1, SB Bhuyan1, SB Das2, N Deka2, HS Barthakur2 
1 Department of Endocrinology, Andhra Medical College, Visakhapatnam-17, India
2 Department of Neurology, Andhra Medical College, Visakhapatnam-17, India

Correspondence Address:
M P Baruah
Department of Endocrinology, Andhra Medical College, Visakhapatnam-17
India

Aim: To report a case with life threatening agranulocytosis induced by anti thyroid drug Carbimazole, which was treated with granulocyte colony stimulating factor (G-CSF) with favorable outcome. Methods: We present the clinical features, laboratory findings, clinical course, relevant monitoring records and outcome of the study patient. Results: A 40 year old lady presented with clinical and biochemical evidence of thyrotoxicosis due to Graves «SQ» disease for eight months. She was being treated with Carbimazole when she started having fever, painful oral ulcers, severe weakness and progressive anemia and agranulocytosis {Absolute Neutrophil Count (ANC) <150cells/ /uL(0.15X10 9 cells/ L)}. There was evidence of ongoing severe sepsis like high fever and elevated serum C-reactive protein. Recombinant-human G-CSF was started at this point and we continued to assess the leukocyte and neutrophil count daily. Both these counts rose insidiously during first 96 hours; however significant response was seen on 5th day after 4 injections with Total Leukocyte Count (TLC) reaching 3,400cells/ /uL (3.4X1 (f cells/L) and ANC 1870cells/juL (1.87 X10 9 cells/L). The counts continued to rise from this point onwards even without G-CSF injections, accompanied by improvement in her general condition. Conclusion: The clinical setting in this patient was suitable for G-CSF treatment. Such a decision was well vindicated by profound leukocytosis and early recovery from clinical symptoms. The shortened window can significantly reduce the risk of potentially fatal outcome.


How to cite this article:
Baruah M P, Bhuyan S B, Das S B, Deka N, Barthakur H S. Granulocyte colony stimulating factor in the treatment anti-thyroid drug induced agranulocytosis.Thyroid Res Pract 2009;6:84-87


How to cite this URL:
Baruah M P, Bhuyan S B, Das S B, Deka N, Barthakur H S. Granulocyte colony stimulating factor in the treatment anti-thyroid drug induced agranulocytosis. Thyroid Res Pract [serial online] 2009 [cited 2021 Jan 19 ];6:84-87
Available from: https://www.thetrp.net/article.asp?issn=0973-0354;year=2009;volume=6;issue=3;spage=84;epage=87;aulast=Baruah;type=0