AGRANULOCYTOSIS INDUCED BY ANTITHYROID THERAPY - EFFECTS OF TREATMENTWITH GRANULOCYTE-COLONY-STIMULATING FACTOR

A 26-year-old woman was admitted to hospital with high fever, severe t onsillitis, and gastroenteritis. Because of Graves' disease she had be en treated with methimazole for 18 months. Leukopenia and agranulocyto sis in combination with a typical bone marrow, exhibiting a complete a rrest of myelopoiesis at the stage of promyelocytes led to the diagnos is of an antithyroid therapy induced agranulocytosis. After 1 week of antibiotic treatment without changes in neutrophil counts, granulocyte colony stimulating factor treatment at a dose of 300 mu g/day subcuta neously was started. Twenty-four hours after the first administration the neutrophil counts began to rise, to 4389/mu l, with a maximum afte r the third administration and stabilizing at normal levels within 10 days. Since agranulocytosis is considered to be a severe and fatal com plication of methimazole therapy, treatment with granulocyte colony st imulating factor seems to be useful for this life-threatening conditio n.