{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:38:23Z","timestamp":1788489503592,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Antithyroid drug-induced agranulocytosis (AIA) (neutrophils &lt;500\/\u00b5L) is a rare but serious complication in the treatment of hyperthyroidism. Methodology: Adult patients with AIA who were followed up at 12 hospitals in Spain were retrospectively studied. A total of 29 patients were studied. The etiology of hyperthyroidism was distributed as follows: Graves\u2019 disease (n = 21), amiodarone-induced thyrotoxicosis (n = 7), and hyperfunctioning multinodular goiter (n = 1). Twenty-one patients were treated with methimazole, as well as six patients with carbimazole and two patients with propylthiouracil. Results: The median (IQR) time to development of agranulocytosis was 6.0 (4.0\u201311.5) weeks. The most common presenting sign was fever accompanied by odynophagia. All of the patients required admission, reverse isolation, and broad-spectrum antibiotics; moreover, G-CSF was administered to 26 patients (89.7%). Twenty-one patients received definitive treatment, thirteen patients received surgery, nine patients received radioiodine, and one of the patients required both treatments. Spontaneous normalization of thyroid hormone values occurred in six patients (four patients with amiodarone-induced thyrotoxicosis and two patients with Graves\u2019 disease), and two patients died of septic shock secondary to AIA. Conclusions: AIA is a potentially lethal complication that usually appears around 6 weeks after the initiation of antithyroid therapy. Multiple drugs are required to control hyperthyroidism before definitive treatment; additionally, in a significant percentage of patients (mainly in those treated with amiodarone), hyperthyroidism resolved spontaneously.<\/jats:p>","DOI":"10.3390\/jcm12206556","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T10:06:36Z","timestamp":1697450796000},"page":"6556","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Therapeutic Management and Long-Term Outcome of Hyperthyroidism in Patients with Antithyroid-Induced Agranulocytosis: A Retrospective, Multicenter Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Carlos","family":"Garc\u00eda G\u00f3mez","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), 28222 Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Navarro","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Roc\u00edo, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Alc\u00e1zar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Severo Ochoa, 28914 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"L\u00f3pez-Guzm\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Complejo Asistencial de \u00c1vila, 05004 \u00c1vila, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-0451","authenticated-orcid":false,"given":"Francisco","family":"Arrieta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2650-8078","authenticated-orcid":false,"given":"Emma","family":"Anda","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8837-4343","authenticated-orcid":false,"given":"Betina","family":"Biagetti","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitari Vall d\u2019Hebr\u00f3n, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Guerrero-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles","family":"Villabona","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9690-3292","authenticated-orcid":false,"given":"Andr\u00e9s Ruiz","family":"de Ass\u00edn Valverde","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Albacete, 02008 Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-9508","authenticated-orcid":false,"given":"Cristina","family":"Lamas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Albacete, 02008 Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Lecumberri","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario La Paz, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Antonio","family":"Rosado Sierra","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Getafe, 28905 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sastre","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Toledo, 45007 Toledo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2017-0694","authenticated-orcid":false,"given":"Juan Jos\u00e9","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), 28222 Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-1985","authenticated-orcid":false,"given":"Pedro","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), 28222 Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1002\/pds.4156","article-title":"Incidence and risk estimate of drug-induced agranulocytosis in Hong Kong Chinese. 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