Irene L. Solomon

Granulocytopenia and hemolytic anemia as complications of propylthiouracil therapy

PROPYLTHIOURACIL is commonly used in the treatment of hyperthyroidism in adults and children. Reported toxic effects of PTU have included leukopenia and granulocytopenia , 1 bone marrow hypoplasia with pancytopeniai2, 3 hypoprothrombine mia,4 rheumatic syndromes with or without associated serum antinuclear antibody titers or positive lupus erythematosus cell preparations, 5-9 and splenomegaly. 9 We have seen no report of PTU-induced hemolytic anemia, the complication observed in the child described below.

The Urologic Manifestations of XO/XY Mosaicism

The mosaic karyotype XO/XY is expressed by a spectrum of genital phenotypes, ranging from normal male through ambiguous genitalia to normal female. The urologist may see some of these patients because of the following clinical presentations: 1) ambiguous genitalia with a chromatin-negative buccal smear, 2) hypospadias with cryptorchidism or 3) cryptorchidism with müllerian remnants, discovered unexpectedly during inguinal operations. Reliable karyotyping is mandatory for diagnosis of XO/XY patients. Management should include laparotomy with excision of any intra-abdominal gonads (testis and/or streak gonad) because these are prone to develop malignancies that may occur before puberty. Female sex assignment and a reconstructive operation are advised in cases with severely deficient virilization of the genitalia.