Graves' disease in a 3 year-old patient with agranulocytosis due to anti-thyroid drugs: Radioiodine ablation therapy as an effective alternative. / Enfermedad de Graves en un paciente de 3 años con agranulocitosis asociada a fármacos antitiroideos: terapia ablativa con radioyodo como una alternativa eficaz.

The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131I ablation therapy. The relevance of the article is that Graves' disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131I at this age, makes this case unique.

The usefulness of the scan with 67Ga-citrate in the multicentric reticulohistiocytosis.

Multicentric reticulohistiocytosis is a rare systemic disease of unknown etiology. It is characterized by erosive arthritis and skin lesions. Diagnosis and treatment should be performed early to avoid sequelaes. We report the case of a 67-year-old man diagnosed with multicentric reticulohistiocytosis and left hip arthorplasty. The patient consulted for local pain in his left leg. Final diagnosis was left prosthetic dislocation. During admission, a bone scintigraphy with (99m)Tc-HDP and scintigraphy with (67)Ga-citrate was performed, showing no evidence of inflammatory activity in pelvis that contraindicating surgery. Besides it showed bilateral uptake in soft tissue of large joints compatible with persistent inflammatory activity secondary to multicentric reticulohistiocytosis. In this case scintigraphy with (67)Ga-citrate, is a useful tool to assess the recovery and extent of disease.