No abstract available.
Agranulocytosis*

No abstract available.
Agranulocytosis* ; Granulocytes* ; Humans

Preoperative preparation of the hyperthyroid patient for thyroidectomy is imperative to avoid perioperative complications due to severe thyrotoxicosis. The mainstay of preparation is the administration of anti-thyroid drugs (ATD). When ATDs cause adverse reactions, an alternative regimen to prepare the patient for definitive management is crucial. We present the case of a 35-year-old Filipino female with Graves’ disease who developed methimazole-induced agranulocytosis. She refused to undergo radioactive iodine (RAI) therapy. She was admitted for thyroidectomy with elevated thyroid hormone levels. She was rapidly prepared for thyroidectomy using high-dose steroid, beta-adrenergic blocker, propylthiouracil (PTU) and Lugol’s solution. The patient’s free thyroxine level decreased after 8 days of treatment, without complications. She then underwent an uneventful subtotal thyroidectomy. In conditions with very limited options, although contraindicated, administration of another ATD may be the last alternative for patients who developed agranulocytosis.
Hyperthyroidism ; Thyroidectomy ; Agranulocytosis ; Iodine

A 51-year-old Caucasian male developed Graves’ thyrotoxicosis following long-standing treatment for hypothyroidism. After a short period of treatment with carbimazole, he developed agranulocytosis and required total thyroidectomy. In this relevant case report, we review several pathogenetic mechanisms that explain the transformation of autoimmune hypothyroidism into Graves’ disease and the possible approaches to the management of agranulocytosis secondary to antithyroid medications. Further studies are required to determine the best way to manage severe thyrotoxicosis when agranulocytosis develops due to antithyroid medications.
Hypothyroidism ; Antithyroid Agents ; Carbimazole ; Agranulocytosis

Methimazole is a widely used and generally well-tolerated antithyroid agent. Adverse reactions occur in 1~5% of patients taking methimazole medication, but these are most commonly transient, benign leukopenia and a skin rash. Severe cholestatic jaundice, combined with agranulocytosis, has been known as a rare complication. Herein, a case of methimazole induced cholestatic jaundice, with agranulocytosis, is reported.
Agranulocytosis* ; Exanthema ; Humans ; Jaundice, Obstructive* ; Leukopenia ; Methimazole

No abstract available.
Agranulocytosis* ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans*

Aceclofenac is a non-steroidal anti-inflammatory drug (NSAIDs) for inflammatory diseases. In this report, we report a serious adverse event (AE) occurred during the phase I clinical trial for a new sustained-release (SR) formulation of aceclofenac. There was a serious adverse event (AE), agranulocytosis, induced by aceclofenac SR form. An open-labeled, repeated-doses, randomized, crossover study was conducted at Kyung Hee University Hospital and 26 Korean healthy male volunteers were enrolled. All subjects received both aceclofenac SR 200 mg once daily and aceclofenac IR 100 mg twice daily for 4 days with 11 days washout period. After 11 days washout period, one subject showed a serious decrease in the segment neutrophil (267/mm3) on a laboratory test prior to the reference drug administration in period 2. We first report a case of agranulocytosis, during a phase I clinical trial.
Agranulocytosis* ; Cross-Over Studies ; Humans ; Male ; Neutrophils ; Volunteers

OBJECTIVES: We attempted to investigate clinical efficacy of risperidone a new antipsychotic agent with high safety and without life-threatening side effect such as agranulocytosis, in refractory schizophrenia compared with a haloperidol, well-known antipsychotic agent. METHODS: Thirty-four subjects(risperidone group 16, haloperidol group 18), who had been proved to be refractory schizophrenics with prospective antipsychotic treatment with at least 2 antipsychotic agents belonging to different chemical groups from each other, were examined with Clinical Global Impression(CGI) and 18-item Brief Psychiatric Rating Scale(BPRS) at 0, 2nd, 4th, 8th, and 12th week from start of drug administration. Those scales were rated in the single-blind manner. RESULTS: End-point response rate of risperidone was 25%(4 subjects), and that of haloperidol was zero. Difference of the response rates between risperidone and haloperidol was statistically significant. Broader spectrum of symptoms was improved with risperidone treatment than with haloperidol. CONCLUSION: Risperidone is an antipsychotic agent that clinicians can primarily and effectively try in the refractory schizophrenics with high safety.
Agranulocytosis ; Antipsychotic Agents ; Haloperidol* ; Prospective Studies ; Risperidone* ; Schizophrenia* ; Weights and Measures

Antithyroid drugs are the most common treatment modality for Graves' disease and are used for the treatment of relapsed Graves' disease in Korea. Agranulocytosis is a rare and severe complication of antithyroid drug therapy, and most cases occur within 3 month after drug treatment. Agranulocytosis can develop in patients who have relapsed Graves' disease and undergo a second course of antithyroid drugs with a prior uneventful course of drug therapy. We report a case of antithyroid drug-induced agranulocytosis in a relapsed Graves' disease patient who had undergone prior uneventful antithyroid drug therapy. We also present a review of the relevant literature.
Agranulocytosis ; Antithyroid Agents ; Graves Disease ; Humans ; Korea ; Recurrence

Several blood dyscrasias associated with clozapine have been well known to clinicians and potentially life threatening agranulocytosis has been widely reported. However, there is little report regarding incidence, progression and associated features of eosinophilia associated with clozapine. In clinical studies, the onset of eosinophilia usually occurs artier 3 to 5 weeks of treatment and rarely were cases fatal with medical complication. We report the first case of severe eosinophilia, bilateral pleural effusion, asicites, hepatitis and cholecystitis associated with clozapine that would be fatal. Eosinophilia occurred after 19 days of treatment with clozapine and all the clinical conditions improved along with interruption of clozapine treatment. It is suggested that eosinophilia may be more severe side effort than has ether been known and close hematologic monitoring should be done during early treatment of clozapine.
Agranulocytosis ; Ascites* ; Cholecystitis ; Clozapine ; Eosinophilia* ; Ether ; Hepatitis* ; Incidence ; Pleural Effusion*