CASE REPORT
Year : 2016  |  Volume : 9  |  Issue : 1  |  Page : 79-81

Carbimazole induced agranulocytosis with life-threatening complications, tremendous response with granulocyte-colony stimulating factor


1 Department of General Medicine, RKDF Medical College Hospital and RC, Bhopal, Madhya Pradesh, India
2 Department of Pathology, PCMS and RC, Bhopal, Madhya Pradesh, India
3 Department of Radiodiagnosis, RKDF Medical College Hospital and RC, Bhopal, Madhya Pradesh, India

Correspondence Address:
Seema Mahant
A312, Old Minal Residency, Bhopal, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.172437

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Agranulocytosis is a rare complication of drug carbimazole (0.23%). We are accounting to present a very interesting and rare case of agranulocytosis and neutropenic sepsis secondary to carbimazole that have tremendous response with recombinant human granulocyte colony-stimulating factor (G-CSF). A 35-year-old woman with hyperthyroidism since 1-month, who developed delayed carbimazole induced agranulocytosis. She presented with a fever, cough, sore throat and painful mouth ulcer since 7 day. Investigations revealed hyperthyroidism with neutropenia, white blood cell of 0.3 × 10 9 (neutrophils of 0.0 × 10 9 /L). Bone marrow aspiration revealed a hypocellular marrow with reduced myelopoiesis with minimal maturation, consistent with drug-induced neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic (Third-generation cephalosporins) regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal on 5 days treatment and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.


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