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      Agranulocitose e tonsilite associadas ao uso de metimazol Translated title: Agranulocytosis with tonsillitis associated with methimazole therapy

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          Abstract

          O tratamento do hipertireoidismo com drogas antitireoidianas pode provocar, em 0,2 a 0,3% dos casos, um importante efeito colateral: a agranulocitose. As complicações infecciosas decorrentes desta condição afetam principalmente a orofaringe, sendo a tonsilite uma de suas manifestações. No presente trabalho, é relatado o caso de uma paciente do sexo feminino, com 33 anos, apresentando odinofagia e febre resistentes à vários antibióticos. A paciente era portadora de hipertireoidismo e estava em uso de metimazol há dois meses. Com o diagnóstico de angina agranulocítica, foi suspensa a droga e iniciado tratamento com ciprofloxacina, sintomáticos e estimulador de colônias granulocíticas, além de fluconazol. A paciente evoluiu satisfatoriamente, recebendo alta dez dias após o início do tratamento. Quinze dias depois, uma tireoidectomia total foi realizada. O objetivo deste relato é ressaltar a importância de se conhecer os efeitos colaterais dos medicamentos, advertir os pacientes sobre os mesmos e alertar os médicos quanto à necessidade de se avaliar o paciente como um todo, investigando sobre outras doenças existentes e medicamentos em uso.

          Translated abstract

          The treatment of hyperthyroidism with antithyroid drugs can cause a significant side effect in 0.2 to 0.3% of the cases: agranulocytosis. Infectious complications caused by this condition affect mainly the throat, and tonsillitis is one of its manifestations. The present study reported the case of a female patient, 33 years old, manifesting odynophagia and fever resistant to many antibiotics. The patient showed hyperthyroidism and had been using methimazole for two months. With the diagnoses of agranulocytic angina, the drug was withdrawn and treatment with ciprofloxacin, symptomatic drugs and granulocytic-colony stimulator, besides fluconazol was started. The patient developed satisfactorily, being discharged ten days after the beginning of the treatment. Fifteen days later, total thyroidectomy was carried out. The purpose of this report was to point out the importance of knowing the side effects of drugs to advise the patients about them and to warn physicians about the need for evaluating the patient as a whole, searching for other current diseases and drugs in use.

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          Otorrinolaringologia

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            Farmacologia básica e clínica

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              Basic and Clinical Endocrinology

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rboto
                Revista Brasileira de Otorrinolaringologia
                Rev. Bras. Otorrinolaringol.
                ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (São Paulo )
                0034-7299
                June 2005
                : 71
                : 3
                : 374-377
                Affiliations
                [1 ] Faculdade de Medicina de Itajubá Brazil
                Article
                S0034-72992005000300019
                10.1590/S0034-72992005000300019
                290b86b7-a99a-4e5e-8d32-3f2578fbbd9e

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0034-7299&lng=en
                Categories
                OTORHINOLARYNGOLOGY

                Otolaryngology
                hyperthyroidism,methimazole,agranulocytosis,tonsillitis,hipertireoidismo,metimazol,agranulocitose,tonsilite

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