Saturday, August 8, 2015

Atypical Thyrotoxicosis Relapse after Carbimazole Discontinuation: A Case Report with Pharmacological View

authors: Sharique Ahmad, Saeeda Wasim, Mohammed Tariq Salman, Mohammed Aqwam Siddiqui,
Nahid Shabnam, Pragya Khanna

A 15-year-old girl who presented with pyrexia of unknown origin of 3 month’s duration was evaluated and examined. She had two palpable axillary lymph nodes associated with mild hepatosplenomegaly and leukopenia (white blood cell count - 1700/cmm). Later was assessed for systemic infection, hematological malignancies and autoimmune disorders. All investigations showed no cause pertaining leukopenia and fever. There was moderate sized goiter in midline of neck with past history of hyperthyroidism associated with tachycardia, tremors, weight loss and thyroid hormone profi le suggesting hyperthyroidism, which prompted to think about thyrotoxicosis associated autoimmunity leading to lymphadenopathy, hepatosplenomegaly and leukopenia. Patient improved rapidly in 3 days after initiation of anti-thyroid drug. 

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