1/11. Morning granulocytopenia in a case of Graves' disease.A 65-year-old woman with Graves' disease presented marked diurnal changes in white blood cell (WBC) and granulocyte counts. Granulocyte count was low and sometimes decreased to 0.2-0.3 x 10(9)/l in the early morning and increased in the afternoon irrespective of her thyroid status. She did not develop sore throat or fever during the investigation period. The present study indicates that these unusual diurnal changes in WBC and granulocyte counts should be considered in the differential diagnosis of agranulocytosis in Graves' disease patients treated with an antithyroid drug.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
2/11. Treatment of carbimazole-induced agranulocytosis and sepsis with granulocyte colony stimulating factor.We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with recombinant human granulocyte colony stimulating factor (G-CSF). A 72-year-old woman with a history of thyrotoxicosis presented with sore throat and fever two weeks after starting carbimazole. Investigations confirmed a leucopenia and neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
3/11. agranulocytosis associated with sulfasalazine.agranulocytosis is a rare but potentially lethal adverse effect of sulfasalazine. We report a case of sulfasalazine-associated agranulocytosis that occurred in a 79-year-old woman who had been taking the drug for approximately seven weeks. The patient had discontinued the drug on her own initiative nine days prior to admission. The patient was admitted with complaints of hoarseness, fever, odynophagia, and malaise. The total white blood cell count was 600/mm3 with a differential of 0% neutrophils, 8% bands, 67% lymphocytes, and 25% monocytes; a bone marrow aspirate and biopsy revealed maturation arrest. The patient's peripheral white blood cell count and differential progressively increased over the nine-day hospital course. Upon discharge the white blood cell count was 12,000 cells/mm3 with 66% neutrophils, 8% bands, 16% lymphocytes, and 10% monocytes. Complete blood counts should be performed periodically in patients receiving sulfasalazine, especially during the first two months of therapy. pharmacists should counsel patients to discontinue the drug and consult their physician immediately if they develop unexplained fever, chills, sore throat, malaise, or other nonspecific illness during the initial two months of treatment.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
4/11. oral manifestations of agranulocytosis associated with methimazole therapy.This paper reports a case of agranulocytosis that developed in a patient with hyperthyroidism two months after the administration of methimazole. The patient manifested symptoms of fever, sore throat, profound leukopenia, and oral complications such as generalized gingival necrosis and mucosa ulceration, which subsequently abated upon withdrawal of the drug. Dental practitioners should be aware of the potential of agranulocytosis associated with methimazole therapy. The oral manifestations should be kept in mind.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
5/11. agranulocytosis associated with procainamide therapy--report of a case.The case of a 69-year-old woman with procainamide-induced agranulocytosis is reported, and literature reports of 14 other such cases are reviewed. The patients was exposed to procainamide, prescribed for atrial fibrillation, for 26 days, with a daily dose of 1.5 to 4 g and a total dose of 57.5 g. She recovered from agranulocytosis after discontinuation of the drug and hospital treatment for 16 days. Among the reported cases of procainamide-induced agranulocytosis, the daily dosage ranged from 750 mg to 4.5 g; the total ingested dose before agranulocytosis was observed ranged from 36.5 to 316.3 g. patients treated with procainamide should be instructed to report any soreness of the mouth, throat or gums; unexplained fever; or any symptoms of upper respiratory tract infection. If white blood cell counts indicate bone marrow depression, the drug should be withdrawn and appropriate evaluation begun at once.- - - - - - - - - - ranking = 0.03502612618841keywords = throat (Clic here for more details about this article) |
6/11. captopril-induced agranulocytosis: a case report.captopril 12.5 mg twice daily was initially administered given to a woman with chronic renal failure and hypertension. Three weeks later, she developed chills, high fever and sore throat. Hemogram showed severe neutropenia; the white cell count showed 600/cu mm; bone marrow aspirate and biopsy revealed a paucity of myeloid series. Antineutrophil antibody was not detected in the serum. The neutrophil counts returned to normal after captopril was discontinued two weeks later. We recommend that the peripheral white blood cell count in patients whom captopril is prescribed must be carefully monitored in the first three months, particularly in those with impaired renal function.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
7/11. agranulocytosis in a patient with thalassaemia major during treatment with the oral iron chelator, 1,2-dimethyl-3-hydroxypyrid-4-one.agranulocytosis developed in a 20-year-old Greek patient with beta-thalassaemia major, 11 weeks after commencing chelation with the oral iron chelator 1,2-dimethyl-3-hydroxypyrid-4-one (L1) and 6 weeks after receiving the drug at a total daily dose of 105 mg/kg. The patient presented with generalised weakness, low-grade fever and sore throat. The total white cell count was 2.0 x 10(9)/l with 0.1 x 10(9)/l neutrophils. The patient was admitted to hospital and successfully treated with intravenous broad-spectrum antibiotics. Neutrophil count recovered 7 weeks later. A number of immunological tests were performed in an attempt to elucidate the cause of agranulocytosis. These investigations gave inconclusive evidence for the presence of a weak IgM antibody to myeloid cells exposed to L1 in this patient. Further studies are required, however, to evaluate the mechanism in any other patient who develops agranulocytosis in association with L1 therapy.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
8/11. methimazole-induced agranulocytosis treated with recombinant human granulocyte colony-stimulating factor (rhG-CSF): a case report.methimazole 5 mg three times daily was prescribed in 1994 spring to a woman, aged 53 years, with relapsed hyperthyroidism. The drug was discontinued six weeks after initiation because of leukopenia. Two weeks still later, the patient developed chills, high fever, and a sore throat. The leukocyte count was 1,100/mm3 with 23% granulocytes, 76% lymphocytes and 1% monocytes. The granulocyte count stopped decreasing only three weeks after the drug was discontinued when the recombinant human granulocyte colony-stimulating factor (rhG-CSF) was given; the patient recovered uneventfully. Thus we recommend that the peripheral leukocyte count of patients who receive methimazole therapy must be carefully monitored during the first three months. Furthermore, the use of rhG-CSF for methimazole-induced agranulocytosis abbreviates the period required for marrow recovery after cessation of this offensive drug.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
9/11. An uncommon cause of oral ulcers.A 25-year-old Hispanic woman presented with painful oral ulcers, a sore throat, and dysphagia of two weeks' duration. She was treated empirically with acyclovir for presumed herpes simplex stomatitis and esophagitis and sent home. A week later, she returned with complaints of worsening sore throat, fever (as high as 38.9 degrees C), and cough producing yellow-green sputum. She had not had chills, shortness of breath, burning on urination, or a change in bowel habits.- - - - - - - - - - ranking = 2keywords = sore throat, throat (Clic here for more details about this article) |
10/11. fever or a soar throat after start of antithyroidal drugs? A medical emergency.We describe two patients who developed granulocytopenia (granulocyte count < 1.0 x 10(9)/1) after treatment with antithyroid drugs. Although, perhaps, an already known side-effect of these drugs, we present these cases in order to stay alert for this serious complication. The first patient developed granulocytopenia upon reinstitution of propylthiouracil after an uncomplicated first course of ATD-treatment. In the second case we report the use of granulocyte colony-stimulating factor (G-CSF) for treatment of a patient with methimazole-induced granulocytopenia. Furthermore, we discuss current concepts concerning pathophysiology, prevention and therapy.- - - - - - - - - - ranking = 0.14010450475364keywords = throat (Clic here for more details about this article) |
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