Fatal Case of Marrow Aplasia after Treatment with Carbimazole

Richardson, Jeremy; Sarkany, I.; Campbell, Charlotte H.

doi:10.1136/bmj.1.4858.364

Cited by 14 publications

(6 citation statements)

References 9 publications

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“…It includes irregular vaginal bleeding, skin petechiae and ecchymosis, or severe Mechanism of antithyroid drugs induced aplastic anemia gastrointestinal hemorrhage. Intracranial hemorrhage had also been reported in previous literature (45,46). Hemorrhage was associated with a decrease in platelet count.…”

Section: Discussionsupporting

confidence: 54%

Clinical characteristics of antithyroid drug-induced aplastic anemia cases over the past 30 years

Cheng

Xia²,

Zhang³

et al. 2023

Front. Endocrinol.

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ObjectiveThe authors aimed to investigate the clinical characteristics of antithyroid drug-induced aplastic anemia cases over the past 30 years.MethodsThe data of patients with antithyroid drug-induced aplastic anemia were retrieved from PubMed and Wanfang Medical Network databases from 1992 to August 2022. The clinical characteristics, such as age distribution, gender tendency, common symptoms, blood cell count, bone marrow features, treatment strategy, and prognosis, were analyzed.ResultsA total of 17 cases (male:female = 1:16) had been retrieved. Patients’ age ranged from 16 to 74 years (median 50 years). Among them, 82.3% (14/17) of the patients were administered methimazole (MMI), and 78.6% of them had MMI ≥30 mg/day. In addition, 88.2% (15/17) of the patients had sore throat and fever, and 47.1% (8/17) of the patients had hemorrhagic symptoms. Aplastic anemia occurred within 6 months after initiation of the antithyroid therapy in 94.1% of the patients. Agranulocytosis (94.1%) was the most common and earliest blood cell change, and 47.1% of the patients experienced progressive platelet decline during the treatment process. The treatments include timely withdrawal of antithyroid drugs, broad-spectrum antibiotics, granulocyte colony-stimulating factor (G-CSF)/granulocyte-macrophage colony-stimulating factor (GM-CSF), glucocorticoids and other immunosuppressive agents, and supportive treatments such as erythrocyte transfusion and platelet transfusion. Moreover, 70.6% of the patients had complete or near-complete remission within 8 days to 6 weeks.ConclusionAplastic anemia is a rare and serious adverse reaction of antithyroid drugs, which is more common in women. It usually occurs during early treatment with high-dose antithyroid drugs. Most patients have a good prognosis after timely drug ceasing and appropriate treatment.

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Section: Discussionsupporting

confidence: 54%

Clinical characteristics of antithyroid drug-induced aplastic anemia cases over the past 30 years

Cheng

Xia²,

Zhang³

et al. 2023

Front. Endocrinol.

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“…In the case of agranulocytosis reported by Fraser et al (1954) the patient had previously had severe skin and joint lesions when given methimazole (" mercazole "; 2-mercapto-I -methylglyoxaline). Recovery ensued when the carbimazole was discontinued, as occurred in the two cases described by Bartels (1953) and Harrison (1954), but in that described by Richardson et al (1954) carbimazole produced a complete and fatal marrow aplasia.…”

Section: Agranulocytosis From Carbimazolementioning

confidence: 87%

Acute Osteomyelitis of Maxilla in Infancy

Haas¹

1955

BMJ

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A woman of 41 complained of "peculiar feelings" in the abdomen, pain in the breasts, and morning sickness. She had not menstruated for eight months. The abdomen " felt tight," and she said it was much larger than usual. Two successive pregnancy tests were negative, and she was shown the results; her comment was: " I question the tests. They may be wrong. I think it's an eight-months pregnancy." The sensations in her abdomen, were described as " like a mouse."She had married in 1947, and was most eager to have a child. No contraceptives were employed, yet she did not

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“…Recovery ensued when the carbimazole was discontinued, as occurred in the two cases described by Bartels (1953) and Harrison (1954), but in that described by Richardson et al (1954) carbimazole produced a complete and fatal marrow aplasia.…”

Section: Agranulocytosis From Carbimazolementioning

confidence: 87%

Agranulocytosis from Carbimazole

Shaw¹

1955

BMJ

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Six weeks later, however, she was readmitted with a small hard swelling on the left cheek and oedema of both eyelids. She was again treated with oral phenylindanedione, 30 mg. daily for six days, followed by 20 mg. daily for six days, and chlortetracycline 250 mg. daily in divided doses, which was continued for three weeks. Progress to recovery was uneventful.Radiological evidence of sequestrum formation could not be demonstrated at any time.The patient was followed up for six months after her final

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Fatal Case of Marrow Aplasia after Treatment with Carbimazole

Cited by 14 publications

References 9 publications

Clinical characteristics of antithyroid drug-induced aplastic anemia cases over the past 30 years

Clinical characteristics of antithyroid drug-induced aplastic anemia cases over the past 30 years

Acute Osteomyelitis of Maxilla in Infancy

Agranulocytosis from Carbimazole

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