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. 2015:2015:680191.
doi: 10.1155/2015/680191. Epub 2015 Feb 24.

Methimazole associated neutropenia in a preterm neonate treated for hyperthyroidism

Dimitrios Angelis  1 , Rita Ann Kubicky  2 , Alan B Zubrow  2
Affiliations

Methimazole associated neutropenia in a preterm neonate treated for hyperthyroidism

Dimitrios Angelis et al. Case Rep Endocrinol. 2015.

Abstract

Maternal Graves' disease is relatively uncommon with an estimated incidence of 0.4%-1% of all pregnancies, but only 1-5% of newborns delivered to mothers with Graves' disease develop overt clinical signs and symptoms of hyperthyroidism. Here, we describe a case of a 1380-gram female neonate who was born at 30-week gestation to a mother with Graves' disease. Our patient presented with hyperthyroidism followed by transient hypothyroidism requiring treatment with levothyroxine. While hyperthyroid, she was treated with methimazole, iodine, and a beta-blocker. 20 days after the initiation of methimazole, she developed neutropenia. The neutrophil counts started to improve immediately after the initiation of the weaning of methimazole. To the best of our knowledge, this is the first case reported in the literature of methimazole induced neutropenia in a preterm infant being treated for neonatal Graves' disease.

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Figures

Figure 1
Figure 1
Free thyroxine (FT4) and thyroid stimulating hormone (TSH) levels and treatment course during hospitalization at our institution. Iodine, methimazole, beta-blocker, and levothyroxine are shown as bars at the end of the graph. The triangle at the end of methimazole bar represents the time that methimazole was started to be tapered.
Figure 2
Figure 2
The absolute neutrophil count (ANC) is shown. Neutropenia was noted after 20 days of methimazole use (DOL 30). Iodine, methimazole, beta-blocker, and levothyroxine are shown as bars at the end of the graph. The triangle at the end of methimazole bar represents the time it was tapered.
See this image and copyright information in PMC

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