ABSTRACT
Anti-thyroid drugs, like carbimazole and propylthiouracil (PTU) are commonly prescribed for the treatment of hyperthyroidism. One should be aware of the side effects of antithyroid medications. Antineutrophil cytoplasmic antibody (ANCA)--associated vasculitis is a potentially life-threatening adverse effect of antithyroidmedications. We report a patient with Graves' disease who developed ANCA positive carbimazole induced vasculitis. The episode was characterized by a vasculitic skin rash associated with large joint arthritis, pyrexia and parotiditis but no renal or pulmonary involvement. He was referred to us for neurological evaluation because he had difficulty in getting up from squatting position and was suspected to have myositis. Carbimazole and methimazole have a lower incidence of reported ANCA positive side effects than PUT. To the best of our knowledge this is the first ANCA positive carbimazole induced vasculitis case reported from India.
Subject(s)
Adult , Antibodies, Antineutrophil Cytoplasmic/adverse effects , Antithyroid Agents/adverse effects , Carbimazole/adverse effects , Graves Disease/complications , Humans , Immunologic Factors/adverse effects , Male , Treatment Outcome , Vasculitis/chemically inducedABSTRACT
To investigate the effects of carbimazole-induced hypothyroidism, and simultaneous administration of thyroxine [thyroid hormone analogue] on the adrenal glands of 10 days' prenatally treated albino rats. A comparative study. Department of Anatomy, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, from 15th July 2001 to 31st August 2001. Ten days old albino rats of either gender, which were delivered by their respective mothers which were originally obtained from Charles River Breeding Laboratories, Brooklyn, Massachusetts, USA, and were cross bred, housed and maintained on the balanced diet in the Animal House of BMSI, JPMC, Karachi. Eighteen prenatally treated albino rats of 10 days old were used in the experiment and divided into three groups: X, Y and Z, comprising 06 animals in each group, i.e. from carbimazole treated mothers [X], carbimazole plus thyroxine treated mothers [Y], and controlled mothers [Z]. At the end of 10th postnatal day all the animals were sacrificed, their adrenal glands were removed, fixed, sectioned, and stained with H and E. The adrenal histology with relation to its width of cortex, zones and number of cells in different zones of cortex were studied. Carbimazole-induced hypothyroidism causes the adrenal atrophy in the adrenals of 10 days' prenatally treated albino rats by decreasing the total width of cortex and its zones especially zona fasciculata. Carbimazole-induced hypothyroidism by carbimazole causes the shrinkage of adrenal cortex in 10 days prenatally treated albino rats
Subject(s)
Male , Female , Animals, Laboratory , Hypothyroidism/pathology , Carbimazole/adverse effects , Adrenal Glands/pathology , Rats , Antithyroid Agents/adverse effectsABSTRACT
Carbimazole induced agranulocytosis is a relatively rare but serious side effect and potentially fatal condition reported in 0.1-0.5% of cases treated with antithyroid medications. We report a young female with Grave's disease who developed agranulocytosis within 3 weeks of initiation of carbimazole, and recovered within 10 days of treatment with a barrier nursing care, broad-spectrum antibiotics, intravenous corticosteroids and granulocyte colony stimulating factor [G-CSF]. Recovery from agranulocytosis in our case seems compatible with similar cases reported in various areas of the world .We could not reach firm conclusion that the use of G-CSF may hasten recovery time. We noticed an immediate increase in WBC's count, especially neutrophils, following corticosteroid administration