DEATH DUE TO AGRANULOCYTOSIS INDUCED BY METHIMAZOLE THERAPY

Abstract

Since the introduction of thiouracil, the antithyroid activity of many compounds has been investigated.¹In 1949, Stanley and Astwood²reported that methimazole (1-methyl-2-mercaptoimidazole, also known as "tapazole") was highly active in 30 cases of hyperthyroidism. Subsequently an additional 185 cases have been reported by various investigators.³All agree that the drug is highly effective. Only Bartels and Sjogren^3dmention the occurrence of toxic reactions. In their series of 100 patients, 6 had a skin rash; treatment with the drug had to be discontinued in 3 of the 6 cases. These figures agree with the earlier reported incidence of skin reactions, which occurred in approximately 5% of patients receiving this drug.⁴At the end of the paper, but not included in their series, Bartels and Sjogren^3dreport that leukopenia occurred in one patient who was being treated with methimazole. Bartels⁵stated that, in a