drugs that cause agranulocytosis
Antithyroid drug induced agranulocytosis
Thiourea antithyroid drugs are divided into two classes and imidazole, commonly used in clinical propylthiouracil and methylthio imidazole (methimazole). The same mechanism of these two drugs, both inhibit the synthesis of thyroid hormone, thereby reducing serum thyroxine levels, improve the symptoms and signs of hyperthyroidism. Curative effect, the long-range (more than 1 ½ years) in the treatment of mild to moderate cure rate was 60% of patients, short (6 months) the cure rate is also up to 40% or more. However, in the course of treatment and must adverse reactions, such as allergic reactions, liver damage and blood system damage and early prevention to be concerned, especially the class of drug-induced agranulocytosis in peripheral blood can not be taken lightly.
Anti-thyroid drug-induced agranulocytosis in the mechanism may be related to the following two factors: First, drugs that inhibit bone marrow cell DNA (dna) synthesis, cell mitosis induced reduction of grain to produce disorder in the peripheral blood induced agranulocytosis. Second, hapten-sensitive drugs as the body''s white blood cells into a complete antigen binding and stimulate the body to produce white blood cell antibodies by the immune response mechanism so that cell damage caused by excessive grain agranulocytosis.
Since the mechanism of two types of the same anti-thyroid drugs, resulting in the mechanism of neutropenia is also similar, so the tw
o types of drugs have side effects between the cross-cutting, and has nothing to do with the dosage. When one type of anti-thyroid drug-induced agranulocytosis when the other drugs should not be used.
Clinical data show that the antithyroid drug induced agranulocytosis incidence rate of about 0.2% to 0.5%, methylthio imidazole than propylthiouracil rate was high. Most of the time of occurrence after treatment at the beginning of the 2 ~ 3 months, the individual can advance to 20 days. Therefore, application of anti-thyroid drugs at the beginning of the first 3 months of peripheral blood white blood cells should be monitored regularly, every 2 to 3 weeks to check 1. To 3 months after treatment may be appropriate to extend the monitoring time, every 1 to 2 months 1 inspection for early detection and early treatment.
Agranulocytosis major impact on the body is to reduce the body''s resistance to pathogenic microorganisms, leading to pathogenic microorganisms easily against body tissues or organs and cause infection. The site most vulnerable to infection and pharyngeal tonsil, followed by the skin, respiratory system and digestive system. Therefore, high fever, sore throat and swollen tonsils, purulent for the early and prominent signs. If this happens during the treatment can not simply consider it as pharyngitis, tonsillitis or the common cold and other diseases, and blood tests should be timely, necessary, possible bone marrow examination. If the WBC count was less than 3 109 / L or less than the total number of granulocytes 1.5 109 / l, and the reduction of the red blood cell-based bone marrow hyperplasia, then, can be diagnosed as agranulocytosis. Been diagnosed in patients with agranulocytosis should be discontinued.
Treatment programs include at least 4 points: Intravenous broad-spectrum antibiotics to control infection; and support given to boost the immune therapy, such as the injection of gamma globulin or immune globulin price; applications rose white drugs, such as vitamin b4, shark liver alcohol, leucogen Division booths or cell (recombinant human granulocyte colony stimulating factor), etc.; combined corticosteroids, can increase the efficacy of the drug rose white blood cells, play a good synergy. The above treatment, patients with good prognosis, most patients in 1 week the temperature drops, the symptoms disappeared, white blood cell count returned to normal, some patients return to normal white blood cells of time may be extended to 10 to 12 days. Recovered after treatment should be avoided by using anti-thyroid drugs again, if necessary, radiation or surgical treatment should be considered. Key words: thyroid thyroid thyroid-related article of women prone to diseases which should not use thyroid surgery in patients with hyperthyroidism treated? Of hyperthyroidism or hypothyroidism may affect fertility look up the mother before pregnancy and thyroid disease, thyroid iodine have anything more to be career women Anti-thyroid function in the etiology of depression and symptoms of thyroid storm thyroid function decline Why?
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