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Hypocalcemia Accompanying Agranulocytosis During Propylthiouracil Therapy

GEORGE E. SHAMBAUGH III, M.D.; NADIM KHOURY, M.D.; JOEL ZONSCHEIN, M.D.; and GLEN W. SIZEMORE, M.D.
[+] Article and Author Information

The authors appreciate the support of Dr. Ronald Vanbuskirk and Dr. Charles Hawker and the secretarial assistance of Ms. June Pedersen.

Supported in part by the Medical Research Service of the Veterans Administration, USPHS Research Grant AM-10699 and Training Grants AM-05071 and AM-01169, and the Schweppe Foundation.


Ann Intern Med. 1979;91(4):576-577. doi:10.7326/0003-4819-91-4-576
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The thiouryline drugs, propylthiouracil and methimazole, share several side-effects including skin rashes, toxic hepatitis, a lupus-like syndrome, serologic abnormalities, drug fevers, and arthritis (1). Agranulocytosis is an unpredictable complication of both and occurs in about 0.3% of patients treated with these drugs (2). We have recently encountered a thyrotoxic patient treated with propylthiouracil who developed agranulocytosis with coexistent symptomatic hypocalcemia. Because thiouryline drugs are used widely and effectively in the medical management of thyrotoxicosis we present this case study that widens the potential spectrum of antimetabolic actions of propylthiouracil to include hypocalcemia, a previously unrecognized complication.

A 28-year-old woman had

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