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자료유형
학술저널
저자정보
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대한내과학회 대한내과학회지 대한내과학회지 제86권 제2호
발행연도
2014.1
수록면
232 - 236 (5page)

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Agranulocytosis is a rare, but life-threatening, adverse effect of methimazole, which usually manifests as an upper respiratoryinfection. Agranulocytosis together with acute appendicitis is especially rare in patients with Graves’ disease taking methimazole. A 44-year-old woman presented to our hospital with abdominal pain and a fever. She had been taking methimazole and propranololfor Graves’ disease for the previous 8 weeks. Her symptoms were compatible with acute appendicitis. Computed tomography of theabdomen revealed acute appendicitis with impending rupture. However, the circulating absolute neutrophil count was 10/mm3. Wemanaged her with antibiotics and granulocyte colony stimulating factor rather than with emergency surgery. The thyrotoxicosis wastreated with intravenous contrast medium while fasting, followed by Lugol’s solution and lithium. After recovering from theneutropenia, she underwent a total thyroidectomy combined with an appendectomy. Here, we report a patient with Graves’ diseasewho developed methimazole-induced agranulocytosis presenting as acute appendicitis.

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