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Thyroidectomy for the treatment of Graves' thyrotoxicosis in thioamide-induced agranulocytosis and sepsis

Knight, Colin L., Cooray, Shamil D., Kulkarni, Jaideep, Borschmann, Michael and Kotowicz, Mark 2017, Thyroidectomy for the treatment of Graves' thyrotoxicosis in thioamide-induced agranulocytosis and sepsis, Endocrinology, diabetes & metabolism, pp. 1-6, doi: 10.1530/EDM-17-0071.

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Title Thyroidectomy for the treatment of Graves' thyrotoxicosis in thioamide-induced agranulocytosis and sepsis
Author(s) Knight, Colin L.
Cooray, Shamil D.
Kulkarni, Jaideep
Borschmann, MichaelORCID iD for Borschmann, Michael orcid.org/0000-0002-8094-1411
Kotowicz, MarkORCID iD for Kotowicz, Mark orcid.org/0000-0002-8094-1411
Journal name Endocrinology, diabetes & metabolism
Article ID 17-0071
Start page 1
End page 6
Total pages 6
Publisher BioScientifica Ltd.
Place of publication Bristol, Eng.
Publication date 2017-09
ISSN 2052-0573
Summary A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol’s iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels. Postoperative recovery was uncomplicated and he was discharged home on thyroxine. There is limited available evidence to guide treatment in this unique cohort of patients who require prompt management to avert impending clinical deterioration. This case report summarises the successful emergent control of thyrotoxicosis in the setting of thioamide-induced agranulocytosis complicated by sepsis, and demonstrates the safe use of multi-modal pharmacological therapies in preparation for total thyroidectomy.
Language eng
DOI 10.1530/EDM-17-0071
Field of Research 110306 Endocrinology
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution Non-Commercial No-Derivatives licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30109157

Document type: Journal Article
Collections: School of Medicine
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Created: Thu, 07 Jun 2018, 13:47:37 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.