Neutropenia and anaemia due to carbimazole-dependent antibodies

Br J Haematol. 2000 Apr;109(1):243-7. doi: 10.1046/j.1365-2141.2000.01978.x.

Abstract

Carbimazole-dependent antibodies to erythrocytes were detected in the sera of three anaemic patients who had been treated with carbimazole for hyperthyroidism. By the use of Rhnull-typed erythrocytes, we could show that some of these were directed against the proteins of the Rh complex. Carbimazole-dependent antibodies eluted from erythrocytes showed no binding to other blood cells. One patient also presented with neutropenia and mild thrombocytopenia. Additional carbimazole-dependent antibodies against the neutrophil-specific Fcgamma receptor IIIb (FcgammaRIIIb, CD16b) and the broadly expressed platelet endothelial cell adhesion molecule 1 (PECAM-1; CD31) were detected in this patient's serum. Surprisingly, the PECAM-1-reactive drug-dependent antibodies were also detectable in the sera of the other two patients with normal leucocyte and platelet counts. We assume that carbimazole can induce cell lineage-specific drug-dependent antibodies that cause cytopenia and also drug-dependent antibodies against the broadly expressed PECAM-1 molecule that may cause mild but not severe cytopenia.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / chemically induced*
  • Antithyroid Agents / adverse effects*
  • Antithyroid Agents / immunology
  • Autoantibodies / blood*
  • Blood Platelets / immunology
  • Carbimazole / adverse effects*
  • Carbimazole / immunology
  • Erythrocytes / immunology
  • Female
  • Humans
  • Neutropenia / chemically induced*
  • Neutrophils / immunology
  • Time Factors

Substances

  • Antithyroid Agents
  • Autoantibodies
  • Carbimazole