{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:10:01Z","timestamp":1756368601659,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,23]]},"abstract":"<jats:p>Thionamides, such as methimazole and propylthiouracil, are used for the management of hyperthyroidism. Agranulocytosis is a rare adverse effect of thionamides and elderly patients are especially vulnerable. Here we discuss a case of an 80-year-old woman who developed agranulocytosis and pneumonia approximately 4 weeks after starting low dose methimazole therapy. Despite aggressive treatment with broad-spectrum antibiotics and granulocyte colony stimulating factor, she developed multiorgan failure and died. Our goals are to identify risk factors common to elderly patients and hopefully improve outcomes in this population when prescribed thionamides.<\/jats:p>","DOI":"10.1136\/bcr-2017-220924","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T07:00:26Z","timestamp":1500274826000},"page":"bcr-2017-220924","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Increased risk for thionamide-induced agranulocytosis in elderly patients: a case presentation and literature review"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6680-4779","authenticated-orcid":false,"given":"Sumera","family":"Bukhari","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, St Francis Medical Center, Seton Hall University, Trenton, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St Francis Medical Center, Seton Hall University, Trenton, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naresh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St Francis Medical Center, Seton Hall University, Trenton, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinuta","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, St Francis Medical Center, Seton Hall University, Trenton, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,17]]},"reference":[{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-98-1-26"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(86)90679-0"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra042972"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1517\/14740338.5.1.107","article-title":"The safety and efficacy of antithyroid drugs","volume":"5","author":"Azizi","year":"2006","journal-title":"Expert Opin Drug Saf"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1991.tb08042.x"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.6","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s40801-016-0091-4","article-title":"Idiosyncratic Drug-Induced Severe Neutropenia and Agranulocytosis in Elderly patients (\u226575\u00a0years): A Monocentric Cohort Study of 61 Cases","volume":"3","author":"Mourot-Cottet","year":"2016","journal-title":"Drugs Real World Outcomes"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.7","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2008.0364"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1507\/endocrj.K05-068","article-title":"The relation of initial methimazole dose to the incidence of methimazole-induced agranulocytosis in patients with graves' disease","volume":"54","author":"Tsuboi","year":"2007","journal-title":"Endocr J"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2003.02007.x"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.10","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2000.00132.x"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.11","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/01.pra.0000442937.61575.26","article-title":"Exploring the potential effect of polypharmacy on the hematologic profiles of clozapine patients","volume":"20","author":"Shuman","year":"2014","journal-title":"J Psychiatr Pract"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.12","first-page":"567","article-title":"[Neutropenia in a patient treated with clozapine in combination with other psychotropic drugs]","volume":"28","author":"S\u00e9n\u00e9chal","year":"2002","journal-title":"Encephale"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.13","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/S0755-4982(04)98884-7","article-title":"Prognostic factors of hematological recovery in life-threatening nonchemotherapy drug-induced agranulocytosis. A study of 91 patients from a single center","volume":"33","author":"Maloisel","year":"2004","journal-title":"Presse Med"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1990.00390150107020"},{"key":"2025082800324530000_2017.jul17_1.bcr-2017-220924.15","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2005.15.292"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-220924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:32:53Z","timestamp":1756366373000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-220924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,17]]},"references-count":15,"alternative-id":["10.1136\/bcr-2017-220924"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-220924","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,7,17]]}}}