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Lee, Ahn, Kim, Oh, and Chung: A Case of Methimazole-induced Agranulocytosis and Kikuchi's Disease in a Patient with Graves' Disease
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2008; 23(6): 420-424.

Published online: 31 December 2008

DOI: https://doi.org/10.3803/jkes.2008.23.6.420

A Case of Methimazole-induced Agranulocytosis and Kikuchi's Disease in a Patient with Graves' Disease

Seung Eun Lee, Jihyun Ahn, Jaetaek Kim, Yeon Sahng Oh, Yun Jae Chung

Division of Endocrinology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Received 13 June 2008       Accepted 24 July 2008

Copyright © 2008 Korean Endocrine Society

Abstract

Methimazole-induced agranulocytosis is a rare, but critical side effect that should be recognized as soon as possible since it may induce a life-threatening condition when it was overlooked. Histiocytic necrotizing lymphadenitis is also called Kikuchi's lymphadenitis, and this is a rare form of lymphadenitis with a self-limited clinical course and this illness is accompanied by cervical lymph node enlargement, fever and malaise. We recently experienced a patient with methimazole-induced agranulocytosis and Graves' disease, and this was accompanied by Kikuchi's disease; the patient presented with sore throat and multiple enlarged cervical lymph nodes. To the best of our knowledge, there is no previous report on methimazole-induced agranulocytosis combined with Kikuchi's disease. Therefore, we report here on this very rare case along with a brief review of the relevant literature.

Keywords: agranulocytosis, Graves' disease, Kikuchi's disease

Figures and Tables

Fig. 1
Neck CT shows multiple enlarged lymph nodes in bilateral submandibular spaces and bilateral internal jugular chain (arrows).
jkes-23-420-g001
Fig. 2
Chest X-ray (A) and CT (B) show multiple nodular lesions on the both lung field (arrow).
jkes-23-420-g002
Fig. 3
Lymphoid cells, histiocyte and karyorrhectic nuclei are noted in the necrotic background (PAP staining, ×400).
jkes-23-420-g003

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