Hypocalcemia Accompanying Agranulocytosis During Propylthiouracil Therapy
Authors: George E. Shambaugh, Nadim Khoury, Joel Zonschein, Glen W. Sizemore
Journal: Annals of Internal Medicine (1979)

Brief Reports1 October 1979Hypocalcemia Accompanying Agranulocytosis During Propylthiouracil TherapyGEORGE E. SHAMBAUGH III, M.D., NADIM KHOURY, M.D., JOEL ZONSCHEIN, M.D., GLEN W. SIZEMORE, M.D.GEORGE E. SHAMBAUGH III, M.D.Search for more papers by this author, NADIM KHOURY, M.D.Search for more papers by this author, JOEL ZONSCHEIN, M.D.Search for more papers by this author, GLEN W. SIZEMORE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-4-576 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe 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...References1. ROSOVE M. Agranulocytosis and antithyroid drugs. West J Med. 1977;126:339-43. MedlineGoogle Scholar2. MOORE F. Toxic manifestations of thiouracil therapy. JAMA. 1946;130:315-19. CrossrefMedlineGoogle Scholar3. HAWKER C. Parathyroid hormone: radioimmunoassay and clinical interpretation. Ann Clin Lab Sci. 1975;5:383-98. MedlineGoogle Scholar4. SIZEMOREGoKAPLANSANZENBACHERMOLTERMULLERARNAUD GVELKC. Relations of calcitonin and gastrin in the Zollinger-Ellison syndrome and medullary carcinoma of the thyroid. N Engl J Med. 1973;268:641-4. CrossrefGoogle Scholar5. SHILS M. Experimental human magnesium depletion. Medicine (Baltimore). 1969;48:61-85. CrossrefMedlineGoogle Scholar6. DAHL J. MCFADDEN SD, EISENBERG E. Idiopathic hypoparathyroidism associated with hyperthyroidism. Ann Intern Med. 1962;57:635-8. LinkGoogle Scholar7. ANASTMOHSKAPLANBURNS CJST. Evidence for parathyroid failure in magnesium deficiency. Science. 1972;177:606-8. CrossrefMedlineGoogle Scholar8. MEDALLEWATERHOUSE RC. A magnesium-deficient patient presenting with hypocalcemia and hyperphosphatemia. Ann Intern Med. 1973;70:76-9. LinkGoogle Scholar9. OPPENHEIMERSCHWARTZSURKS JHM. Propylthiouracil inhibits the conversion of L-thyroxine to L-triiodothyronine. J Clin Invest. 1972;51:2493-7. CrossrefMedlineGoogle Scholar10. WIERSINGATOUBER WJ. The influence of B-adrenoceptor blocking agents on plasma thyroxine and triiodothyronine. J Clin Endocrinol. 1977;45:293-8. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByA review of drug-induced hypocalcemiaDrug-Induced Electrolyte DisordersAgranulocytosis Associated with Antithyroid Drugs Effects of Patient Age and Drug DoseDAVID S. COOPER, M.D., DAVID GOLDMINZ, B.S., ANN A. LEVIN, M.S., PAUL W. LADENSON, M.D., GILBERT H. DANIELS, M.D., MARK E. MOLITCH, M.D., E. CHESTER RIDGWAY, M.D.Thyroid and antithyroid drugsCorrection: Spelling of Author's Name 1 October 1979Volume 91, Issue 4Page: 576-577KeywordsArthritisDrug therapyDrugsFeversHealth services researchHepatitis AHyperthermiaHypocalcemiaRashesResearch grants Issue Published: 1 October 1979 PDF DownloadLoading ...