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*

Agranulocytosis as a side effect of clozapine has been reported to be associated with initial phases of treatment, i.e., first six months. Agranulocytosis with clozapine during the initial phases of treatment has been linked to genetic vulnerability in the form of variations in the human leukocyte-antigen haplotypes. However, there is limited literature on late onset agranulocytosis with clozapine and this has very rarely been linked to human leukocyte-antigen haplotypes vulnerability. In this report we review the existing data on late onset agranulocytosis with clozapine and describe the case of a young man, who developed agranulocytosis with clozapine after 35 months of treatment and was found to have genetic vulnerability in form of being positive for HLA DR4. This case highlights underlying autoimmune immune mechanism in clozapine-induced agranulocytosis and the need for frequent blood count monitoring on clozapine even after the initial 6 months of starting treatment especially in patients with genetic vulnerability to develop this condition.
Agranulocytosis* ; Clozapine* ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Haplotypes ; Humans ; Neutropenia

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

The novel antipsychotic, olanzapine, has structural and pharmacological properties similar to clozaine. Antipsychotic drugs, as well as mood stabilizers, can cause neutropenia, which can progress to life-threatening agranulocytosis if the medication is not discontinued. We report two cases of reversible neutropenia associated with a olanzapine-valproate combination treatment. This report suggests that patients treated with the combination of olanzapine and valproate should be monitored for the occurrence of leukopenia and neutropenia.
Agranulocytosis ; Antipsychotic Agents ; Benzodiazepines ; Humans ; Leukopenia ; Neutropenia ; Valproic Acid

Antipsychotic-induced agranulocytosis is a significant side effect that is known to occur with most of the antipsychotic medications. It usually resolves once the medications are stopped and patients are able to be switched over to another antipsychotic medication. Lurasidone has not been reported to cause leukopenia and neutropenia. This case report is of a patient with a past history of risperidone induced-aganulocytosis developing dose related leukopenia and neutropenia with lurasidone.
Agranulocytosis ; Antipsychotic Agents* ; Humans ; Leukopenia ; Lurasidone Hydrochloride* ; Neutropenia* ; Risperidone