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Antithyroid drug agranulocytosis — SCE Endocrinology MCQ

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EasyThyroidAntithyroid drug agranulocytosisSCE Endocrinology

A 34-year-old woman with Graves' disease on carbimazole develops sore throat and fever. Neutrophil count is 0.4 x 10^9/L. What is the most appropriate management?

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Correct answer: E — Stop carbimazole and treat as agranulocytosis urgently

Carbimazole-induced agranulocytosis is a medical emergency; the drug should be stopped and urgent assessment arranged. Switching to propylthiouracil is unsafe because cross-reactivity can occur and sepsis risk is immediate. Patients on antithyroid drugs should be counselled to report sore throat or fever promptly.

Reference: BNF; NICE NG145