In this report, we described a case of a clinical practice, in which the pharmacist was involved in the treatment of a patient, who was diagnosed with neutrophil deficiency and histiocytic necrotizing lymphadenitis induced by methimazole. The patient was admitted to the hospital for hyperthyroidism and neutrophil deficiency. After anti-infection and antiviral treatment, the patient had poor treatment effect and developed lymph node pain. Clinical pharmacist analyzed medication effects in patient and provided clinical medication advice. Clinical pharmacist considers the high fever may be unrelated to drug fever, bacterial and viral infection. Lymph node pain indicates that clinicians should be aware of the coexistence of histiocytic necrotizing lymphadenitis, and the patient had no fever after using glucocorticoids. This case suggests that clinical pharmacists can better serve the clinic and patients by participating in the clinical treatment process of patients with neutrophil deficiency and histiocytic necrotizing lymphadenitis caused by methimazole and using their professional expertise in pharmacy to improve the rational use of drugs.

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