Korean J Intern Med.
2005 Dec;20(4):335-338. 10.3904/kjim.2005.20.4.335.
Management of a Pregnant Patient with Graves' Disease Complicated by Propylthiouracil induced Agranulocytosis
- Affiliations
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- 1Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. hdyoon@cu.ac.kr
- KMID: 1115259
- DOI: http://doi.org/10.3904/kjim.2005.20.4.335
Abstract
- Relapse and exacerbation of Graves' disease during pregnancy is rare, and thionamide induced agranulocytosis is an uncommon side effect. We report a case of a pregnant woman in her 24th week of gestation that experienced a relapse of Graves' disease that was complicated by propylthiouracil induced agranulocytosis. Following the discontinuation of propylthiouracil and administration of a broad-spectrum of antibiotics, agranulocytosis subsided within 10 days. A total thyroidectomy to avoid any future relapse was planned and a short course of a beta-adrenergic blocker and Lugol solution were prescribed before the operation. At the 28th week of gestation, a total thyroidectomy was performed without complications and thyroxine replacement therapy was commenced. At the 40th week of gestation, labor was induced and a 3, 370 g healthy male infant was born without clinical features of thyrotoxicosis. We report herein on the patient and the treatment options for this rare and complicated case.
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