Jaundice after methimazole use: A case report

Yıl 2024, Cilt: 23 Sayı: 1, 32 - 35, 25.04.2024

Mustafa Ergin

https://doi.org/10.17941/agd.1470546

Öz

Although it is not common after methimazole in the treatment of hyperthyroidism, liver injury and jaundice may develop in a cholestatic pattern. This condition, which can rarely be fatal, usually shows a reversible course after drug discontinuation. Close follow-up of patients and supportive treatment are important. Radioactive iodine or surgical treatment should be recommended instead of antithyroid medication in patients who develop methimazole-associated cholestatic or mixed type liver injury. In this report, a case with methimazole-associated mixed type liver injury with jaundice is presented.

Anahtar Kelimeler

Hyperthyroidism, methimazol, liver injury, cholestasis

Metimazol kullanımı sonrası sarılık: Olgu sunumu

Öz

Hipertiroidi tedavisinde yer alan metimazol sonrası sık görülmemekle beraber kolestatik paternde karaciğer hasarı ve sarılık gelişebilmektedir. Nadiren ölümcül de olabilen bu durum ilaç kesilmesini takiben genellikle geri dönüşlü bir seyir gösterir. Hastaların yakın takibi ve destek tedavisi önemlidir. Metimazol ilişkili kolestatik veya miks (karışık) tip karaciğer hasarı gelişen hastalarda antitiroid ilaç yerine radyoaktif iyot veya cerrahi tedavi önerilmelidir. Bu raporda metimazol ilişkili miks tip karaciğer hasarı gelişmiş sarılıkla prezente olan bir olgu sunulmaktadır.

Anahtar Kelimeler

Hipertiroidi, metimazol, karaciğer hasarı, kolestaz

Kaynakça

• 1. De Leo S, Lee SY, Braverman LE. Hyperthyroidism. The Lancet 2016;388(10047):906-18.
• 2. Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343-421. Erratum in: Thyroid. 2017;27(11):1462.
• 3. Zeng B, Yuan L, Chu J, Yang Y, Lin S. Challenges in early identification of causes and treatment of cholestasis in patients with hyperthyroidism: a case report and literature review. J Int Med Res 2020;48(3):0300060519891018.
• 4. Badiu C. Williams textbook of endocrinology. Acta Endocrinologica (Bucharest) 2019;15(3):416.
• 5. Vitug AC, Goldman JM. Hepatotoxicity from antithyroid drugs. Horm Res 1985;21(4):229-34.
• 6. LiverTox: clinical and research information on drug-induced liver injury: National Institute of Diabetes and Digestive and Kidney Diseases; 2012.
• 7. Ramos-Bonner LS, Goldberg TH, Moyer S, Anastasopoulou C. Methimazole-induced cholestatic jaundice in an elderly hyperthyroid patient. Am J Geriatr Pharmacother. 2007;5(3):236-40.
• 8. Ji H, Yue F, Song J, Zhou X. A rare case of methimazole-induced cholestatic jaundice in an elderly man of Asian ethnicity with hyperthyroidism: A case report. Medicine 2017;96(49):e9093.
• 9. Zou H, Jin L, Wang L-R, et al. Methimazole-induced cholestatic hepatitis: two cases report and literature review. Oncotarget 2016;7(4):5088-91.
• 10. Rosenbaum H. Agranulocytosis and toxic hepatitis from methimazole. J Am Med Assoc. 1953;152(1):27.
• 11. Chayma S, Belaid R, Naourez A, Lamine H, Raja A. Methimazole-induced cholestatic jaundice. Endocrine Abstracts. 2022;81:EP993.Bioscientifica.
• 12. Mikhail NE. Methimazole-induced cholestatic jaundice. South Med J. 2004;97(2):178-82.