| A Case of Acute Appendicitis in a Patient with Methimazole-Induced
Agranulocytosis |
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A Ram Hong, Kyeong Seon Park, Yong Suk Jo, Do Joon Park, Young Joo Park, Jung Hee Kim |
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Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea |
| 그레이브스병에서 메티마졸 투여 후 발생한 무과립구증과
급성충수염 |
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홍아람, 박경선, 조용숙, 박도준, 박영주, 김정희 |
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서울대학교 의과대학 내과학교실 |
Correspondence:
Jung Hee Kim, Tel: +82-2-2072-4839, Fax: +82-2-764-2199, Email: jhkxingfu@gmail.com
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Received: 9 May 2013 • Revised: 21 June 2013 • Accepted: 26 August 2013 |
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| This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits
unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Abstract |
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Agranulocytosis is a rare, but life-threatening, adverse effect of methimazole, which usually manifests as an upper respiratory infection. Agranulocytosis together with acute appendicitis is especially rare in patients with Graves’ disease taking methimazole. A 44-year-old woman presented to our hospital with abdominal pain and a fever. She had been taking methimazole and propranolol for Graves’ disease for the previous 8 weeks. Her symptoms were compatible with acute appendicitis. Computed tomography of the abdomen revealed acute appendicitis with impending rupture. However, the circulating absolute neutrophil count was 10/mm3. We managed her with antibiotics and granulocyte colony stimulating factor rather than with emergency surgery. The thyrotoxicosis was treated with intravenous contrast medium while fasting, followed by Lugol’s solution and lithium. After recovering from the neutropenia, she underwent a total thyroidectomy combined with an appendectomy. Here, we report a patient with Graves’ disease who developed methimazole-induced agranulocytosis presenting as acute appendicitis. (Korean J Med 2014;86:232-236) |
| Key Words:
Graves' disease; Agranulocytosis; Acute appendicitis |
| 주제어:
그레이브스병; 무과립구증; 급성충수염 |
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