Evidence map›Paper›PMID 42803895›Full record

ArticleEndocrine2026

Neutrophil recovery characteristics in patients with severe antithyroid drug-induced agranulocytosis: A 12-year retrospective study.

Yuanlin Luo, Xiayue Fan, Qianqian Yang, Hui Liu, Yufeng Liu, Yanan Wang, Hui Guo, Bingyin Shi, Bao Zhang, Yayi He

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Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

10 authors.

Yuanlin LuoDepartment of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Xiayue FanMed-X Institute, Center for Immunological and Metabolic Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Qianqian YangDepartment of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Hui LiuBiobank, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Yufeng LiuBiobank, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Yanan WangMed-X Institute, Center for Immunological and Metabolic Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Hui GuoDepartment of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Bingyin ShiDepartment of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Bao ZhangCollege of Medicine and Forensic, Health Science Center of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China. zhangbao_814@mail.xjtu.edu.cn.
Yayi HeDepartment of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China. 008099@xjtufh.edu.cn.

Funding

Natural Science Foundation for Young Scientists of Shanxi Province 82300882the General project, Shaanxi Science and Technology Research 2022SF-103
6 · The paper itself

Abstract

backgroundAntithyroid drug-induced agranulocytosis (TIA) is a serious adverse effect in Graves' disease treatment. This study aims to analyze neutrophil recovery patterns in TIA patients.

methodsWe conducted a 12-year retrospective study of patients with Graves' disease diagnosed with TIA. Primary objective was to characterize the recovery patterns of absolute neutrophil count (ANC) after severe agranulocytosis. Secondary objective was to identify factors associated with leukocytosis during granulocyte colony-stimulating factor (G-CSF) treatment using univariate and multivariate logistic regression.

results48 TIA patients were included; 43 (89.6%) had a nadir ANC ≤ 0.1 × 10⁹/L (the severe agranulocytosis). Among 36 patients with detailed records, 77.8% had ANC ≤ 0.1 × 10⁹/L persisting 3-8 days. In the slow recovery group (> 3 days, n = 41), 62.5% exhibited rapid increase, with ANC surging from (0.1-0.5) × 10⁹/L to ≥ 0.5 × 10⁹/L within one day. 18 patients developed leukocytosis during G-CSF treatment. Univariate analysis showed that severe agranulocytosis lasting > 3 days significantly associated with leukocytosis (OR = 4.47, 95% CI: 1.05-18.94, P = 0.042). This association remained significant after adjusting for total G-CSF dose (OR = 7.72, 95% CI: 1.37-43.38, P = 0.020), and after further adjusting for sex, age, and total G-CSF dose (OR = 9.66, 95% CI: 1.52-61.36, P = 0.016).

conclusionsIn most severe TIA patients, neutrophil recovery exhibited a biphasic pattern, with ANC recovering rapidly after prolonged severe agranulocytosis. Close monitoring is essential to avoid G-CSF overstimulation, particularly in patients with prolonged severe agranulocytosis.

Indexed as

AgranulocytosisAntithyroid AgentsGraves DiseaseNeutrophilsAdultFemaleGranulocyte Colony-Stimulating FactorHumansLeukocyte CountMaleMiddle AgedRetrospective StudiesAntithyroid AgentsGranulocyte Colony-Stimulating FactorAntithyroid drug-induced agranulocytosisGranulocyte colony-stimulating factorGraves'' diseaseLeukocyte dynamicsNeutrophil recovery

Identifiers

PMID42803895

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.