그레이브스병에서 메티마졸 투여 후 발생한 무과립구증과급성충수염
A Case of Acute Appendicitis in a Patient with Methimazole-Induced Agranulocytosis
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Agranulocytosis is a rare, but life-threatening, adverse effect of methimazole, which usually manifests as an upper respiratoryinfection. Agranulocytosis together with acute appendicitis is especially rare in patients with Graves’ disease taking methimazole. A 44-year-old woman presented to our hospital with abdominal pain and a fever. She had been taking methimazole and propranololfor Graves’ disease for the previous 8 weeks. Her symptoms were compatible with acute appendicitis. Computed tomography of theabdomen revealed acute appendicitis with impending rupture. However, the circulating absolute neutrophil count was 10/mm3. Wemanaged her with antibiotics and granulocyte colony stimulating factor rather than with emergency surgery. The thyrotoxicosis wastreated with intravenous contrast medium while fasting, followed by Lugol’s solution and lithium. After recovering from theneutropenia, she underwent a total thyroidectomy combined with an appendectomy. Here, we report a patient with Graves’ diseasewho developed methimazole-induced agranulocytosis presenting as acute appendicitis.
Abstract
Agranulocytosis is a rare, but life-threatening, adverse effect of methimazole, which usually manifests as an upper respiratoryinfection. Agranulocytosis together with acute appendicitis is especially rare in patients with Graves’ disease taking methimazole. A 44-year-old woman presented to our hospital with abdominal pain and a fever. She had been taking methimazole and propranololfor Graves’ disease for the previous 8 weeks. Her symptoms were compatible with acute appendicitis. Computed tomography of theabdomen revealed acute appendicitis with impending rupture. However, the circulating absolute neutrophil count was 10/mm3. Wemanaged her with antibiotics and granulocyte colony stimulating factor rather than with emergency surgery. The thyrotoxicosis wastreated with intravenous contrast medium while fasting, followed by Lugol’s solution and lithium. After recovering from theneutropenia, she underwent a total thyroidectomy combined with an appendectomy. Here, we report a patient with Graves’ diseasewho developed methimazole-induced agranulocytosis presenting as acute appendicitis.
참고문헌 (10)
- Cooper DS, "Antithyroid drugs", N Engl J Med, 311, pp.1353~1362 (1984)
- 정귀홍, "재발된 그레이브스병 환자에서 항갑상샘약제 재투여 후 발생한 무과립구증 1예", 대한내과학회지, 75(3), pp.362~366 (2008), 대한내과학회
- Ryan ME, "Typhlitis complicating methimazoleinduced agranulocytosis", Gastrointest Endosc, 29, pp.299~302 (1983)
- Takata K, "Methimazole-induced agranulocytosis in patients with Graves' disease is more frequent with an initial dose of 30 mg daily than with 15 mg daily", Thyroid, 19, pp.559~563 (2009)
- Urbach DR, "Typhilitis", Can J Surg, 42, pp.415~419 (1999)
- Rhee CM, "Association between iodinated contrast media exposure and incident hyperthyroidism and hypothyroidism", Arch Intern Med, 172, pp.153~159 (2012)
- Streetman DD, "Diagnosis and treatment of Graves disease", Ann Pharmacother, 37, pp.1100~1109 (2003)
- Pearce EN, "Hyperthyroidism: advantages and disadvantages of medical therapy", Surg Clin North Am, 84, pp.833~847 (2004)
- Salama A, "Immune-mediated agranulocytosis related to drugs and their metabolites: mode of sensitization and heterogeneity of antibodies", Br J Haematol, 72, pp.127~132 (1989)
- Peralta FG, "Arjona R. Incidence of neutropenia during treatment of bone-related infections with piperacillin-tazobactam", Clin Infect Dis, 37, pp.1568~1572 (2003)