그레이브스병 환자에게서 메티마졸 복용 후 발생한 무과립구증에 동반된 Kikuchi병

• Published in: Endocrinology and metabolism (Seoul) Vol. 23; no. 6; pp. 420 - 424
• Main Authors: 이승은, Seung Eun Lee, 안지현, Ji Hyun Ahn, 김재택, Jae Taek Kim, 오연상, Yeon Sahng Oh, 정윤재, Yun Jae Chung
• Format: Journal Article
• Language: Korean
• Published: 대한내분비학회 30.12.2008
• Subjects: agranulocytosis; Graves` disease; Kikuchi`s disease
• ISSN: 2093-596X

항갑상선제에 의한 무과립구증과 Kikuchi병이 동시에 발생한 예는 보고된 바 없다. 저자 등은 그레이브스병으로 진단받은 25세 여자 환자가 메티마졸을 복용하던 중 발생한 무과립구증과 이와 동반된 Kikuchi병 1예를 경험하였다. 무과립구증은 과립구집락자극인자와 경험적 항생제 투여로 치료하였으며, Kikuchi병은 대증적 치료를 통해 발열이 소실되었다. 중등도의 그레이브스병 안구병증이 동반되었고, 갑상선종 또한 매우 컸으므로 갑상선기능항진증의 궁극적인 치료를 위해 갑상선절제술을 시행하였다. 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. (J Korean Endocr Soc 23:420~424, 2008)