{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:12:03Z","timestamp":1782846723863,"version":"3.54.5"},"reference-count":7,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"Abstract<\/jats:title>\n \n Objective.<\/jats:bold>\n Graves\u2019 disease is an autoimmune disease of the thyroid gland causing hyperthyroidism due to thyroid-stimulating hormone receptor autoantibodies. A rare, but serious complication of anti-thyroid drug therapy is agranulocytosis, a critical reduction in granulocytes leading to neutropenia and impaired infection defense.\n <\/jats:p>\n \n Case report.<\/jats:bold>\n We report a case of a 32-year-old woman with Graves\u2019 disease who developed propylthiouracil-induced agranulocytosis and pancytopenia with concurrent severe infection. The patient was treated with antibiotics and granulocyte colony-stimulating factor ultimately undergoing total thyroidectomy.\n <\/jats:p>\n \n Conclusion.<\/jats:bold>\n The case highlights a rare, but potentially life-threatening complication of antithyroid drug therapy. We emphasize the importance of close monitoring of patients treated with anti-thyroid drugs. Early recognition and prompt intervention are crucial as agranulocytosis is not always symptomatic. Additionally, early thyroidectomy should be considered in women of childbearing age as recurrent disease flares and therapeutic switching not only increase the risk of agranulocytosis and infection, but may also delay pregnancy.\n <\/jats:p>","DOI":"10.2478\/enr-2025-0022","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:00:21Z","timestamp":1762866021000},"page":"195-198","source":"Crossref","is-referenced-by-count":1,"title":["Propylthiouracil-induced agranulocytosis complicated by severe infection in a patient with Graves\u2019 disease: A case report"],"prefix":"10.2478","volume":"59","author":[{"given":"Jens Skjoldan","family":"Svenningsen","sequence":"first","affiliation":[{"name":"Department of Endocrinology , Amager and Hvidovre Hospital , Hvidovre , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djordje","family":"Marina","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , Amager and Hvidovre Hospital , Hvidovre , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2026063015000804581_j_enr-2025-0022_ref_001","doi-asserted-by":"crossref","unstructured":"Cooper DS. Antithyroid drugs. N Engl J Med 352, 905\u2013917, 2005.","DOI":"10.1056\/NEJMra042972"},{"key":"2026063015000804581_j_enr-2025-0022_ref_002","doi-asserted-by":"crossref","unstructured":"Kahaly GJ, Bartalena L, Hegedus L, Leenhardt L, Poppe K, Pearce SH. European Thyroid Association Guideline for the management of Graves\u2019 hyperthyroidism. Eur Thyroid J 7, 167\u2013186, 2018.","DOI":"10.1159\/000490384"},{"key":"2026063015000804581_j_enr-2025-0022_ref_003","unstructured":"Kamitani F, Nishioka Y, Koizumi M, Nakajima H, Kurematsu Y, Okada S, Kubo S, Myojin T, Noda T, Imamura T, Takahashi Y. Antithyroid drug-induced leukopenia and G-CSF administration: a long-term cohort study. Sci Rep 13, 19336, 2023."},{"key":"2026063015000804581_j_enr-2025-0022_ref_004","doi-asserted-by":"crossref","unstructured":"Liu Y, Li Q, Xu Y, Chen Y, Men Y. Comparison of the safety between propylthiouracil and methimazole with hyperthyroidism in pregnancy: A systematic review and meta-analysis. PLoS One 18, e0286097, 2023.","DOI":"10.1371\/journal.pone.0286097"},{"key":"2026063015000804581_j_enr-2025-0022_ref_005","doi-asserted-by":"crossref","unstructured":"Noh JY, Inoue K, Suzuki N, Yoshihara A, Fukushita M, Matsumoto M, Imai H, Hiruma S, Ichikawa M, Koshibu M, Sankoda A, Hirose R, Watanabe N, Sugino K, Ito K. Dose-dependent incidence of agranulocytosis in patients treated with methimazole and propylthiouracil. Endocr J 71, 695\u2013703, 2024.","DOI":"10.1507\/endocrj.EJ24-0135"},{"key":"2026063015000804581_j_enr-2025-0022_ref_006","doi-asserted-by":"crossref","unstructured":"Tajiri J, Noguchi S, Murakami T, Murakami N. Antithyroid drug\u2013induced agranulocytosis: the usefulness of routine white blood cell count monitoring. Arch Intern Med 150, 621\u2013624, 1990.","DOI":"10.1001\/archinte.1990.00390150107020"},{"key":"2026063015000804581_j_enr-2025-0022_ref_007","doi-asserted-by":"crossref","unstructured":"Vicente N, Cardoso L, Barros L, Carrilho F. Antithyroid drug-induced agranulocytosis: state of the art on diagnosis and management. Drugs R D 17, 91\u201396, 2017.","DOI":"10.1007\/s40268-017-0172-1"}],"container-title":["Endocrine Regulations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/enr-2025-0022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:30:18Z","timestamp":1782844218000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/enr-2025-0022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,11,10]]},"published-print":{"date-parts":[[2025,1,1]]}},"alternative-id":["10.2478\/enr-2025-0022"],"URL":"https:\/\/doi.org\/10.2478\/enr-2025-0022","relation":{},"ISSN":["1336-0329"],"issn-type":[{"value":"1336-0329","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,1]]}}}