Carbimazole-induced agranulocytosis treated with granulocyte colony-stimulating factor [GCSF]: a report of two cases

Agranulocytosis is the most serious and potentially fatal side-efiect of antithyroid drug therapy. We report two cases presenting with carbimazole-induced agranulocyotsis. The first patient received 20 mg of carbimazole daily, and developed agranulocytosis within one month of commencementoftherapy. The second patientpresented with agranulocytosis complicated by a thyroid storm following Ingestion 60 mg of carbimazole, daily for two months. Both patients were treated with 300 mg of granulocyte colony factor [GCSF] subcutaneously [in addition to discontinuation of their anti-thyroid drugs] and broadspectrum antibiotics for neutropenic sepsis. The total white and neutrophil counts returned to baseline following five and six days of treatment, respectively, with the resolution the use of GCSF in the treatment will be being discussed

Predictors of quality of life in renal transplant recipients

The presence of end stage renal disease [ESRD] has a negative impact on patients' quality of life [QOL]. Renal transplantation is well-recognized to provide a better QOL than other modalities of renal replacement therapy. To evaluate the QOL in our renal transplant recipients and to determine the factors that influences it at our institution. Cross-sectional observational study. University Kebangsaan Hospital, Malaysia. Renal transplant recipients between 18 and 75 years who have been transplanted more than one year. QOL was assessed using the Short Form-36 questionnaire that has been validated in the Malay language. Thirty nine patients [29 male, 10 female] were enrolled. The SF-36 scores were physical functioning [47.85 +/- 6.93], role physical functioning [49.51 + 11.08], general health [51.43 +/- 6.22], vitality [60.53 +/- 6.61], social functioning [50.85 +/- 9.26], mental health [55.74 +/- 7.16], bodily pain [58.55 +/- 7.51], role emotional functioning [49.09 +/- 12.01], physical component summary [49.37 +/- 6.87] and mental component summary [55.23 +/- 6.66]. Predictors of QOL were education [p < 0.001], serum albumin [p = 0.017] and hemoglobin [p = 0.02]. Increasing age negatively impacted physical functioning [p = 0.029]. We also found those who received a commercial transplant had a lower mental health compared to those done locally [p = 0.031]. Predictors of QOL in our renal transplant cohort were age, education, serum albumin and hemoglobin