J Korean Soc Endocrinol.  1998 Dec;13(4):617-621.

A Case of Methimazole Induced Agranulocytosis Complicated with Deep Neck Abscess

• Lee KW
• Lee SK
• Chung YS
• Kim HM
• Kim YJ
• Hong EK
• Chae BN
• Lee JH
• Ha CY
• Park JS

Abstract

The thiourea derivatives, propylthiouracil and methimazole are in widespread use for the treatment of hyperthyroidism. The untoward side effects of these drugs are not infrequent and agranulocytosis is the most serious side effect them. We observed one case of methimazole induced agranulocytosis complicated by deep neck abscess. A 54-year-old woman was admitted because of fever, chilling and sore throat for 1 week. The symptom was developed after receiving methimazole 30mg daily day due to hyperthyroidism during last 3 months. Physical examination revealed hyperemic, enlarged tonsils and tender swelling of the right lower neck The peripheral blood total leukoeyte count was 1,500/mm' (absolute neutrophil count, ANC 9) and a peripheral blood smear revealed few neutrophil. The patient was administered G-CSF 2 mg/kg daily, and on the fifth day of hospitalization, fever subsided and ANC increased to 3,431. On the 11th day, fever developed again and the tenderness and swelling in both lower neck area were aggrevated. Computed tomography of the neck was performed, and revealed a large deep neck abscess. After pus aspiration and antibiotics therapy, the neck abscess was disappeared.

MeSH Terms

Abscess*
Agranulocytosis*
Anti-Bacterial Agents
Female
Fever
Granulocyte Colony-Stimulating Factor
Hospitalization
Humans
Hyperthyroidism
Methimazole*
Middle Aged
Neck*
Neutrophils
Palatine Tonsil
Pharyngitis
Physical Examination
Propylthiouracil
Suppuration
Thiourea
Anti-Bacterial Agents
Granulocyte Colony-Stimulating Factor
Methimazole
Propylthiouracil
Thiourea