Antithyroid drugs have been used for more than 50 years for the management of hyperthyroidism. Most patients tolerate treatment well but some may develop life-threatening side effects such as agranulocytosis, aplastic anemia and cholestatic hepatitis. A 45-year-old female was diagnosed with severe hyperthyroidism. Treatment with Carbimazole 30 mg/day was initiated. Within six weeks following th...

BACKGROUND Clozapine is the treatment of choice in drug-resistant schizophrenia. Lamotrigine is a mood stabiliser recommended as combined treatment strategy in clozapine-resistant patients. There are cases of late-onset agranulocytosis reported in literature. Some are associated with clozapine or lamotrigine, others with the combination of both. CASE REPORT The article presents a case of rapi...

Ticlopidine is an oral antiplatelet agent frequently utilized in the treatment of cerebrovascular disease and is rarely associated with severe bone marrow suppression, typically aplastic anemia. Reports in the literature of isolated agranulocytosis are few, although they may be associated with significant morbidity and mortality. A case is reported of an elderly woman who developed febrile agra...

Chlorpromazine-induced agranulocytosis is an uncommon disorder associated with a high frequency of fatality. We describe two patients with chlorpromazine-induced granulocytosis in whom granulocyte colony stimulating factor (G-CSF) administration enhanced the speed of neutrophil recovery. No toxicity was noted with G-CSF and both patients made a successful recovery. We propose there is a role fo...

Agranulocytosis is a rare condition with a reported incidence ranging from one to five cases per million population per year. Most commonly, agranulocytosis is secondary to chemotherapeutic agents, however, other medications have also been associated with it. An immune mediated destruction of circulating granulocytes and/or granulocyte precursors secondary to drug-dependent or drug-induced anti...

Ticlopidine is associated with a relatively high incidence of agranulocytosis and aplastic anemia. We have shown that other drugs associated with agranulocytosis are metabolized to reactive metabolites by activated human neutrophils or by HOCl, which is the major oxidant produced by activated neutrophils. We set out to test the hypothesis that ticlopidine also fits this pattern and is oxidized ...

Agranulocytosis is a rare but serious complication of antithyroid drug therapy, and an up-to-date understanding of this topic is important. Both direct toxicity and immune-mediated responses have been described as possible mechanisms. Some major susceptibility loci have recently been identified, which may lead the diagnosis of agranulocytosis into a genomic era. Onset is acute and patients pres...

C lozapine is an atypical antipsychotic that is effective in treatment resistant schizophrenia. The National Institute for Health and Clinical Excellence (NICE) guidelines for schizophrenia specify that ‘‘in individuals with evidence of treatment resistant schizophrenia, clozapine should be introduced at the earliest opportunity’’. A severe adverse effect of clozapine that limits its more wides...

BACKGROUND Antithyroid drug (ATD)-induced agranulocytosis is rare but may cause fatal complications in patients with thyrotoxicosis during treatment with thionamide-derived drugs. From our previous experience, we note that 2 of 11 such patients died in a 10-year retrospective study. METHODS We reviewed thirteen patients who developed agranulocytosis from 7,466 patients with hyperthyroidism wh...

Antithyroid drugs can be a rare cause of agranulocytosis (0.5% of treated patients). Suspension of these drugs is mandatory in these patients and may result in worsening hyperthyroidism. We report the case of a 27-year-old woman who is 3 months post-partum, breastfeeding, and suffering with Graves' disease hyperthyroidism treated first with methimazole and then with propylthiouracil due to a me...