BMJ Case Reports 2010; doi:10.1136/bcr.05.2010.2993
  • Unexpected outcome (positive or negative) including adverse drug reactions

Successful treatment of methimazole-induced severe aplastic anaemia in a diabetic patient with other co-morbidities

  1. Gerry Castillo3
  1. 1Medicine Department, University of the Philippines Philippine General Hospital, Manila, Philippines
  2. 2Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
  3. 3Section of Hematology, Department of Medicine, UP-Philippine General Hospital, Manila, Philippines
  1. Correspondence to Cindy V Josol, josolcindy{at}yahoo.co006D


A 55-year-old Filipina with Grave's disease, diabetes, hypertension, bronchial asthma, Parkinson's disease and a history of adverse drug reaction to penicillin consulted due to high-grade fever and sore throat. Patient was diagnosed with aplastic anaemia secondary to methimazole and was treated with high-dose granulocyte colony stimulating factor, thrombopoietin and mesterolone. Antibiotics used included levofloxacin, clindamycin, amikacin and fluconazole. Due to bleeding and slow recovery of blood parameters, 30 units of platelets and 7 units of packed red blood cells were transfused during her 22-day admission. This case presents a life-threatening adverse drug reaction in a patient with co-morbid conditions that complicate recovery and limit one's therapeutic options.


  • Competing interests None.

  • Patient consent Obtained.

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