Endocrine Abstracts (2014) 34 P412 | DOI: 10.1530/endoabs.34.P412

Are patients aware of the risk of agranulocytosis when taking antithyroid drugs?

Vincent Chau, Julie Andrew, Emma Ward, Ramzi Ajjan & Robert Murray


The Leeds Teaching Hospitals NHS Trust, Leeds, UK.


Background: Hyperthyroidism affects 1.3% of the population. The antithyroid drugs (ATD), carbimazole and propylthiouracil, can induce agranulocytosis, a rare but potentially life threatening side-effect with a prevalence of 0.10–0.15%. We assessed the adequacy of our patient’s knowledge of this side-effect.

Methods: Patients on ATD completed a questionnaire before attending clinic. The questionnaire consisted of nine questions detailing information they had received and knowledge of how they should respond if they become unwell on ATD. Data were collected over a 3-week period.

Results: 39 patients completed the questionnaire. 30 patients (77%) said they received information regarding side-effects when ATD were commenced; eight patients (21%) said they did not; and one patient (3%) was unsure. Most information was given verbally (32), and others include letters (11), cards (9) and leaflets (1). Only 19 patients (49%) patients said the information given was understandable. Most patients had not experienced side-effects (18). The most common side-effects reported were sore throat (8), lethargy, and malaise (6). When asked what they would do in the event of a sore throat, most patients (62%) said they will see their GP or attend A+E. Only seven patients (18%) knew that they needed a blood test. Most patients said they would obtain medical input immediately (36%) or same day (36%). Only 20 patients (51%) said they would stop ATD in the event of a sore throat, and 18 patients (46%) knew to restart ATD if blood test was normal.

Conclusion: This audit shows inadequate patient awareness of the potential life threatening side-effect of ATD. We have since introduced a credit card sized ATD information card for patients commencing ATD. It provides instructions for patients and healthcare professionals to follow when infections occur. We aim to re-audit 12 months after introduction of this new card to assess the impact.

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