抗甲状腺剤による無顆粒球症の発症様式について

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We studied the patterns of the onset of antithyroid drug-induced agranulocytosis. From 1975 to 1990, 19,050 patients with Graves' disease receiving treatment with antithyroid drugs were seen at our clinic. For all patients with Graves' disease treated with an antithyroid drug, a routine white blood cell count was done every 2 weeks until euthyroid state was gained, and a count was done once every moth thereafter. Of these, 70 were found to have agranulocytosis. Agranulocytosis was defined as a granulocyte count of 500/mm3 or less. In only 19 of the 70 was agranulocytosis detected after the occurrence of infection (symptomatic: classical agranulocytosis). The remaining 51 patients were asymptomatic when agranulocytosis was detected during routine white blood cell and granulocyte count monitoring. However, 17 of the 51 patients became symptomatic several days after the withdrawal of antithyroid drug treatment (shifted from asymptomatic to symptomatic agranulocytosis). Thirty-four patients had no symptoms of infection throughout the course of the disease (asymptomatic agranulocytosis).<BR>In conclusion, 1) We found three patterns in the onset of antithyroid drug-induced agranulocytosis: classical (symptomatic), a shift from asymptomatic to symptomatic, and asymptomatic agranulocytosis, 2) Unexpectedly, classical (symptomatic) agranulocytosis was seen in only 19 of the 70 patients, 3) We were again reminded of the importance of routine white blood cell and granulocyte count monitoring.
一般社団法人日本内分泌学会の論文

抗甲状腺剤による無顆粒球症の発症様式について

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