Đặc điểm lâm sàng, cận lâm sàng và một số yếu tố liên quan ở bệnh nhân basedow có giảm bạch cầu hạt do thuốc kháng giáp trạng tổng hợp

Abstract

OF ANTITHYROID DRUGS - INDUCED NEUTROPENIA IN PATIENTS WITH GRAVES’ DISEASE

Objectives: To describe the clinical, laboratory features and related factors of antithyroid drugs - induced neutropenia in patients with Graves’ disease.

Participants and

Methods: A retrospective cross-sectional study was conducted in Department of Endocrinology and Diabetes of Bach Mai Hospital from August 2019 to July 2025. 45 patients with Graves' disease, who developed antithyroid drug-induced neutropenia, were recruited.

Results: The mean age of the patients was 41.8 ± 13.2 years, with females accounting for 86.7%. A total of 42 patients were treated with Methimazole at a mean dose of 18.1 ± 6.3 mg/day, and 3 patients were treated with Propylthiouracil at a mean dose of 233.3 ± 57.8 mg/day. 97.8% of patients developed neutropenia within the first three months of treatment. Fever and sore throat were the most common clinical symptoms, mainly associated with acute pharyngitis or tonsillitis. 20% of patients had neutropenia (500–1500/µl), whose mean lowest neutrophil count was 800 ± 254/µl, and the mean recovery time to ≥1500/µl was 4.8 ± 2.8 days. Meanwhile, 80% patients suffered agranulocytosis (≤500/µl) with a mean lowest neutrophil count of 46 ± 88/µl, and the mean recovery time to ≥1500/µl was 6.8 ± 3.9 days. The lowest neutrophil count was negatively correlated with serum CRPhs level (r= -0,36, p<0,05) recovery time (r= -0.4) and treatment time (r= -0.604) (p<0.001). Our study did not observe any correlation between antithyroid drug type, dosage and the lowest neutrophil count.

Conclusions: Neutropenia induced by antithyroid drugs is a rare but serious complication due to the high risk of infection. Patients should be counseled and closely monitored during the first three months of therapy to reduce mortality rates and the healthcare cost burden.