alexa Isolated Thrombocytopenia Due To Transient Methimazole Toxicity In Acute Ischemic Liver Failure
ISSN: 2155-9864

Journal of Blood Disorders & Transfusion
Open Access

Like us on:
OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Share This Page

Additional Info

Loading
Loading Please wait..
 

7th World Hematologists Congress
May 08-09, 2017 Barcelona, Spain

Payam Pourhassani, Erika Correa and Sneha Patel
Drexel University College of Medicine, USA
Posters & Accepted Abstracts: J Blood Disord Transfus
DOI: 10.4172/2155-9864-C1-023
Abstract
Background: Methimazole is an anti-thyroid medication in the thioamide group that includes propylthiouracil and carbimazole. These medications are well known causes of agranulocytosis (0.1-0.5%). Other blood dyscrasias such as thrombocytopenia and aplastic anemia are rare. Liver dysfunction can interfere with hepatic metabolism of these drugs. We report a case of thrombocytopenia secondary to transiently-reduced hepatic metabolism of methimazole in a patient with temporary ischemic liver damage from cardiogenic shock. Case Description: A 91-year-old male with history of ischemic cardiomyopathy, ESRD, and hyperthyroidism presented to the ED with vague abdominal pain. Medications included methimazole 5 mg every other day, aspirin, clopidogrel, erythropoietin with HD, and midodrine, which were all continued throughout the hospitalization. On exam, he was hypotensive with cold extremities and crackles. Echocardiogram revealed a decrease in ejection fraction from 50-55% to 5-10%. He was diagnosed with cardiogenic shock and started on dobutamine infusion. Prior to initiation of dobutamine, he had a transient episode of complete AV block causing marked hypotension. The following morning, his liver enzymes were markedly elevated, with AST 1009, ALT 1398, alkaline phosphatase 129, Total-bilirubin 1.69, INR 1.4. There were no physical exam findings of liver disease, and right-upper-quadrant ultrasound was unremarkable. These values gradually returned to normal over the course of a week. Initial platelet count was 131,000-dropping to 91,000 on the first day after hepatic injury. After a HIT score calculation of four, heparin prophylaxis was discontinued. A nadir of 26,000 was reached, with a gradual return to 133,000 that paralleled the recovery of liver enzymes. HIT antibodies were eventually negative. Conclusion: This case highlights the importance of hepatic metabolism of methimazole and the potential for toxicity occurring secondary to acute liver injury. It is important to be cognizant of not only the well-described agranulocytosis, but also rare idiosyncratic reactions like thrombocytopenia.
Biography

Email: payam.pourhassani@drexelmed.edu

image PDF   |   image HTML
 
Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsonline.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsonline.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsonline.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsonline.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsonline.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsonline.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsonline.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsonline.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsonline.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsonline.com

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

materialsci@omicsonline.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsonline.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsonline.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsonline.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsonline.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsonline.com

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords