Hi doctor,
Thanks for your answer!
The story is, my mum had hyperthyroidism 7 weeks ago, before the doctor gave her Tapazole, she did a WBC baseline test, WBC was 3.5 and Neutrophil# was 1.5, they were both lower than normal level. I don't know whether the doctor reviewed the result or not, she never warned us or took any action to prevent neutropenia from happening. After 6 weeks medicine, my mum developed a very serious side effect, which was neutropenia, the Neutrophil# was 0 last week, we had to go to hospital last week and experienced a lot pressure.
My questions are: Do you think it was the doctor's malpractice? Should the doctor have noticed the low baseline WBC level and taken action to prevent neutropenia from happening by stopping Tapazole or using other medicine?
Thanks a lot!
billses
A low WBC is not uncommon in Graves Hyperthyroidism. Again, there is not anything to "prevent" the neutropenia induced by Tapazole -- the key is close monitoring (about every 6 weeks).
I cannot comment on "malpractice" as it appears things were monitored and severe neutropenia is simply bad luck in most cases. Hopefully it has resolved and your mom is doing better.
Certainly would avoid PTU and treat the hyperthyroidism with I-131 (or less favorably surgery).
YES; and NO, there is not a med to protect against the decrease caused by tapazole but in the event of severe decrease one can use injections to increase the WBC.
Likely best to avoid tapazole (or PTU) and use RAI or surgery to treat the hyperthyroidism.