Endocrine Abstracts

Introduction: Agranulocytosis represents a serious complication of thyreostatic (ATD) treatment. The aim of our work was to determine how often did agranulocytosis occur in Graves’ disease patients admitted to the thyroid treatment department of our clinic for RAI treatment between the years 1999 and 2014.

Patients and methods: We have retrospectively analysed 699 patients (572 women and 127 men at the average age of 51.5±12.9 years). 327 (47%) of them took carbimazole (CBZ), 293 (42%) took methimazole (MMI) and 79 (11%) took propylthiouracyl.

Results: Agranulocytosis was the reason for RAI treatment in 10 out of 699 patients. There were 9 women and 1 man affected; at the average age of 51±21.9 years. In 7 cases, the agranulocytosis occurred after MMI. In 3 cases it was after CBZ. After CBZ was recalculated to the corresponding dose of MMI, the average dose of ATD was 22.7±12.9 mg MMI/day. The time span between the initiation of the ATD therapy and the development of agranulocytosis was 20–85 days. 8 patients experienced the symptoms, while in 2 cases the agranulocytosis was diagnosed by chance from a routine blood count check. The average duration of agranulocytosis was 7.6±3.2 days. 5 patient were administered G-CSF (9.6±3.4 days) and 5 patients were not (5.6±1.5 days).

Conclusion: The occurrence of agranulocytosis in our population of patients was 1.43%, while the literary data indicate a prevalence of 0.2–0.5%. In all the patients the agranulocytosis developed early in first three months. One fifth of the patients was without any symptoms. Application of G-CSF did not reduce the duration of agranulocytosis