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Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea
BACKGROUND: Antithyroid drugs (ATDs) can lead to the development of agranulocytosis, which is the most serious adverse effect. Characteristics of ATD-induced agranulocytosis (AIA) have seldom been reported due to the rarity. In this study, we characterized the clinical features for AIA in Korean pat...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Endocrine Society
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722401/ https://www.ncbi.nlm.nih.gov/pubmed/26394729 http://dx.doi.org/10.3803/EnM.2015.30.4.475 |
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author | Kim, Hee Kyung Yoon, Jee Hee Jeon, Min Ji Kim, Tae Yong Shong, Young Kee Lee, Min Jin Kim, Bo Hyun Kim, In Joo Joung, Ji Young Kim, Sun Wook Chung, Jae Hoon Kang, Ho-Cheol |
author_facet | Kim, Hee Kyung Yoon, Jee Hee Jeon, Min Ji Kim, Tae Yong Shong, Young Kee Lee, Min Jin Kim, Bo Hyun Kim, In Joo Joung, Ji Young Kim, Sun Wook Chung, Jae Hoon Kang, Ho-Cheol |
author_sort | Kim, Hee Kyung |
collection | PubMed |
description | BACKGROUND: Antithyroid drugs (ATDs) can lead to the development of agranulocytosis, which is the most serious adverse effect. Characteristics of ATD-induced agranulocytosis (AIA) have seldom been reported due to the rarity. In this study, we characterized the clinical features for AIA in Korean patients. METHODS: We retrospectively reviewed data from patients with AIA diagnosed between 1997 and 2014 at four tertiary hospitals. Agranulocytosis was defined as an absolute neutrophil count (ANC) below 500/mm(3). RESULTS: The mean age of the patients (11 males, 43 females) was 38.2±14.9 years. Forty-eight patients (88.9%) with AIA had fever and sore throat on initial presentation, 20.4% of patients developed AIA during the second course of treatment, and 75.9% of patients suffered AIA within 3 months after initiation of ATD. The patients taking methimazole (n=39) showed lower levels of ANC and more frequent use of granulocyte-macrophage colony-stimulating factor than propylthiouracil (n=15) users. The median duration of agranulocytosis was 5.5 days (range, 1 to 20). No differences were observed between the long (≥6 days) and short recovery time (≤5 days) groups in terms of age, gender, ATDs, duration of ATDs, or initial ANC levels. Four patients (7.4%) who were taking ATDs for less than 2 months died of sepsis on the first or second day of hospitalization. CONCLUSION: The majority of AIA incidents occur in the early treatment period. Considering the high fatality rate of AIA, an early aggressive therapeutic approach is critical and patients should be well informed regarding the warning symptoms of the disease. |
format | Online Article Text |
id | pubmed-4722401 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Korean Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-47224012016-01-27 Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea Kim, Hee Kyung Yoon, Jee Hee Jeon, Min Ji Kim, Tae Yong Shong, Young Kee Lee, Min Jin Kim, Bo Hyun Kim, In Joo Joung, Ji Young Kim, Sun Wook Chung, Jae Hoon Kang, Ho-Cheol Endocrinol Metab (Seoul) Original Article BACKGROUND: Antithyroid drugs (ATDs) can lead to the development of agranulocytosis, which is the most serious adverse effect. Characteristics of ATD-induced agranulocytosis (AIA) have seldom been reported due to the rarity. In this study, we characterized the clinical features for AIA in Korean patients. METHODS: We retrospectively reviewed data from patients with AIA diagnosed between 1997 and 2014 at four tertiary hospitals. Agranulocytosis was defined as an absolute neutrophil count (ANC) below 500/mm(3). RESULTS: The mean age of the patients (11 males, 43 females) was 38.2±14.9 years. Forty-eight patients (88.9%) with AIA had fever and sore throat on initial presentation, 20.4% of patients developed AIA during the second course of treatment, and 75.9% of patients suffered AIA within 3 months after initiation of ATD. The patients taking methimazole (n=39) showed lower levels of ANC and more frequent use of granulocyte-macrophage colony-stimulating factor than propylthiouracil (n=15) users. The median duration of agranulocytosis was 5.5 days (range, 1 to 20). No differences were observed between the long (≥6 days) and short recovery time (≤5 days) groups in terms of age, gender, ATDs, duration of ATDs, or initial ANC levels. Four patients (7.4%) who were taking ATDs for less than 2 months died of sepsis on the first or second day of hospitalization. CONCLUSION: The majority of AIA incidents occur in the early treatment period. Considering the high fatality rate of AIA, an early aggressive therapeutic approach is critical and patients should be well informed regarding the warning symptoms of the disease. Korean Endocrine Society 2015-12 2015-12-31 /pmc/articles/PMC4722401/ /pubmed/26394729 http://dx.doi.org/10.3803/EnM.2015.30.4.475 Text en Copyright © 2015 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/3.0/ 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 non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Hee Kyung Yoon, Jee Hee Jeon, Min Ji Kim, Tae Yong Shong, Young Kee Lee, Min Jin Kim, Bo Hyun Kim, In Joo Joung, Ji Young Kim, Sun Wook Chung, Jae Hoon Kang, Ho-Cheol Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea |
title | Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea |
title_full | Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea |
title_fullStr | Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea |
title_full_unstemmed | Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea |
title_short | Characteristics of Korean Patients with Antithyroid Drug-Induced Agranulocytosis: A Multicenter Study in Korea |
title_sort | characteristics of korean patients with antithyroid drug-induced agranulocytosis: a multicenter study in korea |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722401/ https://www.ncbi.nlm.nih.gov/pubmed/26394729 http://dx.doi.org/10.3803/EnM.2015.30.4.475 |
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