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Related Experiment Videos

Methimazole-induced hepatotoxicity.

Kenneth A Woeber1

  • 1Department of Medicine, University of California, San Franscisco, California 94143-1640, USA.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|December 7, 2002
PubMed
Summary
This summary is machine-generated.

Methimazole, a common treatment for Graves' hyperthyroidism, can cause severe cholestasis. Physicians should monitor patients for this rare but serious side effect, especially older patients on higher doses.

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Area of Science:

  • Endocrinology
  • Hepatology
  • Pharmacology

Background:

  • Graves' hyperthyroidism is an autoimmune disorder requiring treatment with antithyroid drugs.
  • Methimazole is a widely prescribed thionamide for managing hyperthyroidism.
  • Hepatotoxicity is a known, albeit uncommon, adverse effect of thionamide therapy.

Observation:

  • A case of severe cholestasis developed in a 36-year-old woman treated with methimazole for hyperthyroidism.
  • Symptoms included pruritus, jaundice, dark urine, and abdominal discomfort, appearing 19 days after initiating methimazole.
  • Laboratory and imaging studies confirmed a cholestatic reaction attributed to methimazole.

Findings:

  • Review of 30 published cases revealed 19 instances of cholestatic hepatotoxicity linked to methimazole or carbimazole.
  • The patient experienced a slow but complete recovery after methimazole discontinuation.
  • Older age and higher drug dosage were identified as risk factors for cholestatic injury.

Implications:

  • Clinicians must remain vigilant for hepatotoxicity, specifically cholestasis, associated with thionamide medications.
  • Awareness of risk factors like patient age and methimazole dosage is crucial for early detection and management.
  • This case underscores the importance of monitoring liver function during antithyroid drug therapy.