J Korean Endocr Soc.  2006 Dec;21(6):548-551.

A Case of Methimazole-induced Pancytopenia: Successful Treatment with Recombinant Human Granulocyte Colony-stimulating Factor

• Lee JH
• Lee J
• Sung SH
• Bae SH
• Kim SG
• Oh HK

Abstract

Methimazole has remained the cornerstone for the treatment of hyperthyroidism since 1940's and it is a well-tolerated antithyroid drug. Pancytopenia is one of the major side effects of methimazole, but its occurrence is very rare. There have been some case reports about methimazole-induced pancytopenia that was treated with recombinant human granulocyte colony-stimulating factor (G-CSF), but its usefulness is still controversial. We present here a case of a 50-year-old female who had been treated with methimazole for hyperthyroidism and she subsequently presented pancytopenia. G-CSF was given for 10 days and she successfully recovered from the pancytopenia.

Keyword

Hyperthyroidism; Methimazole; Pancytopenia; Recombinant human granulocyte colony-stimulating factor

MeSH Terms

Female
Granulocyte Colony-Stimulating Factor*
Granulocytes*
Humans*
Hyperthyroidism
Methimazole
Middle Aged
Pancytopenia*
Granulocyte Colony-Stimulating Factor
Methimazole

Figure

• 

  Fig. 1 Peripheral blood smear shows pancytopenia at day 4 (×400, Wright stain).

• 

  Fig. 2 Bone marrow aspiration shows hypocellularity for her age with adequate megakaryocyte. Mature myeoid and erythroid series are markedly decreased (×400, Wright stain).

• 

  Fig. 3 Diagrammatic description of the patient's course from day of hospital admission. G-CSF, granulocyte colony-stimulating factor.

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