The authors describe the case of a 49-year-old woman who developed a
goiter, mild symptoms of hyperthyroidism, and grossly elevated thyroid
function tests after 2 years of treatment with lithium carbonate. Thyroid
microsomal autoantibodies were also present. She was retreated with
propylthiouracil and improved, but within 3 months she developed
agranulocytosis. Propylthiouracil was discontinued, and the patient was
treated with antibiotics and recovered. She was then given 131I to control
her hyperthyroidism. The case is an example of the rare association of
hyperthyroidism with lithium, which usually suppresses thyroid function,
and demonstrates that lithium carbonate cannot prevent agranulocytosis
caused by propylthiouracil.
Abstract Teaser