{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:40:35Z","timestamp":1792269635731,"version":"4.4.0"},"reference-count":15,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Carbimazole is a widely used medication to treat Graves\u2019 disease, although it can rarely cause acquired aplastic anemia, a complication that happens in less than 0.01% of people. Case Presentation: We report a 36-year-old woman treated with supratherapeutic dose carbimazole who, after approximately six months of treatment, developed high grade fever, severe menorrhagia, spontaneous epistaxis, and pancytopenia. Her bone marrow biopsy showed severe bone marrow failure with only 5% cellularity and trilineage hypoplasia. Other potential causes were ruled out. Immediate discontinuation of carbimazole was done, and supportive care, including blood transfusions, broad-spectrum antibiotics, G-CSF, and eltrombopag, was started. The patient deteriorated during her hospital stay, developed neutropenic sepsis and acute respiratory failure from diffuse alveolar hemorrhage, which required intubation and pulse steroid therapy. She was stabilized and discharged, with a referral to a tertiary medical center for starting antithymocyte globulin (ATG) immunosuppressive therapy, which she subsequently completed; two months after discharge she was transfusion independent with near-normalization of her blood counts. Conclusions: This case serves as a stark reminder of how lethal thionamide-induced bone marrow failure can be, highlighting the vital need for immediate drug cessation, swift intensive care, and thorough patient education on early warning signs.<\/jats:p>","DOI":"10.3390\/reports9030287","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:05:46Z","timestamp":1787735146000},"page":"287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Carbimazole-Induced Severe Acquired Aplastic Anemia in a Patient with Graves\u2019 Disease: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"given":"Rahaf A.","family":"Alghamdi","sequence":"first","affiliation":[{"name":"Department of Medicine, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2028-7536","authenticated-orcid":false,"given":"Hind A.","family":"Alshankiti","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7066-1939","authenticated-orcid":false,"given":"Adel F.","family":"Al-Marzouki","sequence":"additional","affiliation":[{"name":"Department of Hematology, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia"},{"name":"Hematology Research Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah 21589, Saudi Arabia"},{"name":"Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1538-6770","authenticated-orcid":false,"given":"Yara M.","family":"Daous","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia"},{"name":"Department of Pathology, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref_1","first-page":"465","article-title":"Aplastic anemia during antithyroid drug therapy in hyperthyroidism: A case report","volume":"4","author":"Gaman","year":"2008","journal-title":"Acta Endocrinol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1089\/105072504323150787","article-title":"Antithyroid drug-induced agranulocytosis: Special reference to normal white blood cell count agranulocytosis","volume":"14","author":"Tajiri","year":"2004","journal-title":"Thyroid"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1056\/NEJMra042972","article-title":"Antithyroid drugs","volume":"352","author":"Cooper","year":"2005","journal-title":"N. 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Haematol."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/287\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:24:10Z","timestamp":1787736250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["reports9030287"],"URL":"https:\/\/doi.org\/10.3390\/reports9030287","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}