ABSTRACT
Objective:
To retrospectively analyze the
bone marrow characteristics of
methimazole-induced
agranulocytosis and other hematologic damage, and to explore its correlation with clinical features and
prognosis.
Methods:
The
bone marrow and clinical
parameters of 20
patients of Graves′
disease diagnosed with
methimazole-induced
agranulocytosis at the First Affiliated
Hospital of Xi′an Jiaotong
University from January 2000 to December 2022 were collected. The intergroup differences in
bone marrow characteristics and
granulocyte recovery
time were analyzed. Differences in peripheral
blood and
bone marrow characteristics between
patients with single
agranulocytosis and
pancytopenia were compared. Besides,
literature review of the
bone marrow characteristics of
methimazole-induced
hematologic diseases was conducted.
Results:
Compared to
patients with
bone marrow characteristics of
granulocyte and precursor maturation disorders(Type Ⅱ),
patients with aplastic
marrow(Type Ⅰ) had significant decreases in the proportions of
granulocytes in all phases( P<0.05).
Patients with
bone marrow characteristics of Type Ⅰ had a significant increase in the proportion of the
lymphocyte system [51.00%(41.50%, 75.50%) vs 22.00%(14.00%, 35.00%), P=0.002], and got a longer to recovery
time [(6.58±1.68)d vs(3.71±1.60)d, P=0.003]; Correlation
analysis suggested the
granulocyte to
erythrocyte ratio was negatively correlated with the
granulocyte recovery
time( r=-0.520, P=0.023), and the proportion of the
bone marrow lymphocyte was positively correlated with
granulocyte recovery
time( r=0.622, P=0.004). Compared to
patients with single
agranulocytosis,
patients with
pancytopenia had a markedly longer
hospital stay duration [(27.14±5.27)d vs(14.15±7.36)d, P=0.001].
Literature review suggestsed that
methimazole may cause various degrees of damage to
blood system and
bone marrow.
Conclusion:
Methimazole can induce a variety of hematologic damages.
Analysis of
bone marrow characteristics can
aid in further
prognosis assessment. Clinicians should be vigilant about potential hematologic adverse reactions when using
methimazole and promptly
diagnose and treat them to prevent serious consequences.
