- 期刊
Necrotizing Ulcerative Gingivitis in a Patient with Methimazole-Induced Agranulocytosis
壞死性牙齦炎發生於一位因服用抗甲狀腺素（甲硫嗎唑）引發顆粒性白血球缺乏症的病人
摘要
顆粒性白血球缺乏症常由藥物引起，發生率低但致命性高。一位38歲女性因3天的喉嚨痛及牙齦脹痛而到急診就診。抽血檢查發現白血球數低下。這位女性過去健康狀態良好，約一個多月前因被診斷甲狀腺機能亢進而開始服用抗甲狀腺素（methimazole 5mg一天兩次）。縱然白血球數有回昇，可是給予抗生素（pepiracillin/tazobactam 4.5g每8小時及後來的amoxicillin/clavulanate 1.2g每8小時）治療及抗菌液潄口（每500ml含sodium borate 30g, sodium bicarbonate 30, glycerin 66g, phenol 6ml）時，成效不彰。直到類固醇（Hydrocortisone 100mg每8小時）的使用，症狀才有明顯的改善。而類固醇的使用在治療壞死性牙齦炎上所扮演的角色為何，則需更多的臨床研究來證實。
並列摘要
Agranulocytosis, which is often caused by drugs, is a rare but life-threatening disorder. A 38-year-old woman visited the emergency department with a sore throat and gum swelling for 3 days. Neutropenia was found via blood examination. She had been diagnosed with hyperthyroidism one month previously and had started methimazole 5 mg twice a day. The symptoms did not improve much with antibiotics (piperacillin/tazobactam 4.5g every 6 hours and amoxicillin/clavulanate 1.2g every 8 hour) and an antiseptic mouthwash (each bottle has 500 ml and contains sodium borate 30g, sodium bicarbonate 30, glycerin 66g, phenol 6 ml) even after the WBC count returned to normal. The symptoms dramatically improved after the use of intravenous hydrocortisone 100mg every 8 hours. Further clinical studies are indicated in determining the role of steroids in the treatment of necrotizing ulcerative gingivitis.