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Carbimazole Agranulocytosis — RACP Paediatrics MCQ

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HardEndocrinologyCarbimazole AgranulocytosisRACP Paediatrics

A 15-year-old girl with Graves disease on carbimazole develops a sore throat and fever. Urgent FBC shows WCC 0.8 x 10^9/L with neutrophils 0.1 x 10^9/L. What has occurred?

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Correct answer: B — Carbimazole-induced agranulocytosis

Agranulocytosis is a rare but potentially fatal complication of carbimazole (and propylthiouracil). Patients must be warned to seek immediate medical attention for sore throat, mouth ulcers, or fever while on antithyroid drugs. Treatment involves stopping the drug, blood cultures, and empirical broad-spectrum antibiotics.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Hyperthyroidism