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相關文獻
- Antithyroid Drug-induced Agranulocytosis
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題名 | Antithyroid Drug-induced Agranulocytosis=抗甲狀腺藥物引起之顆粒性白血球缺乏症 |
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作者 | 孫銘聰; 蔡正浩; 石光中; | 書刊名 | Journal of the Chinese Medical Association |
卷期 | 72:8 2009.08[民98.08] |
頁次 | 頁438-441+CA81 |
分類號 | 415.635 |
關鍵詞 | 顆粒性白血球缺乏症; 抗甲狀腺藥物; 甲硫基咪唑; 丙基硫氧嘧啶; 硫代酰胺; Agranulocytosis; Antithyroid drugs; Methimazole; Propylthiouracil; Thioamide; |
語文 | 英文(English) |
英文摘要 | Antithyroid drugs are widely used to treat hyperthyroidism, especially Graves’ disease, but they tend to cause agranulocytosis, which increases the mortality rate. Granulocyte colony-stimulating factor decreases the duration of recovery from agranulocytosis. We retrospectively studied cases of antithyroid drug-induced agranulocytosis over the past 10 years in a northern Taiwan medical center. A clinical evaluation was conducted, including a review of complete blood cell counts and differential counts. Four cases were included in this analysis. Agranulocytosis persisted in 2 cases despite a change in therapy from propylthiouracil to methimazole. Fever, sore throat, and diarrhea were common symptoms of agranulocytosis. Initial white blood cell counts ranged from 450 to 1,710/μL. Only 1 case had a positive result from a throat swab culture (Staphylococcus aureus). Three of 4 cases received granulocyte colony-stimulating factor therapy, and the recovery time ranged from 3 to 13 days. All of the patients recovered from agranulocytosis. We concluded that: (1) conducting a routine complete blood cell count is beneficial in alerting caregivers to the possibility of agranulocytosis; (2) educating patients about the common symptoms of agranulocytosis may contribute to an early diagnosis; (3) providing granulocyte colony-stimulating factor therapy to patients results in good prognosis; and (4) monitoring for cross-reactions between drugs should be performed to prevent further episodes of agranulocytosis. |
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