Agranulocytosis secondary to anti thyroid drugs

This refers to the idiosynchratic reaction which can occur with any anti-thyroid drugs, and is characterised by neutropaenia or agranulocytosis.

General examination

Thorough general examination is required to seek evidence of infection and to assess the patient's thyroid status.

Skin

Examine the patient for any rash which may also be associated with anti thyroid drug use and might have prompted the patient to have their blood test.

Cardiovascular examination

Full cardiovascular examination is mandatory looking for signs of sepsis and for control of thyrotoxicosis.

Respiratory examination

Respiratory infections are common in immunocompromised patients.

Gastro-intestinal examination

Examine the mouth and oral cavity with care for signs of ulcers, and sore throat in the patient with neutropaenia.