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[Jaundice caused by methimazole].

J Findor1, E Bruch Igartúa, J Sorda

  • 1Hospital de Clínicas José de San Martín (U.B.A.), Dto. de Medicina, Mar del Plata, Argentina.

Acta Gastroenterologica Latinoamericana
|January 1, 1991
PubMed
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Methimazole therapy can cause cholestatic jaundice in women, appearing around 30 days into treatment. While liver injury is prolonged, it ultimately resolves after drug discontinuation.

Area of Science:

  • Hepatology
  • Pharmacology
  • Endocrinology

Background:

  • Methimazole is a common antithyroid drug used to treat hyperthyroidism.
  • Drug-induced liver injury (DILI) is a significant concern with various medications, including antithyroid agents.
  • Cholestatic jaundice is a specific pattern of liver dysfunction characterized by impaired bile flow.

Observation:

  • Three female patients developed cholestatic jaundice during methimazole therapy, approximately 30 days after initiation.
  • Hepatitis A and B markers were negative, and patients had no history of alcohol abuse or other hepatotoxic drug use.
  • Clinical presentation included marked elevation of alkaline phosphatase and gamma-glutamyltranspeptidase, with moderate increases in aminotransferases.

Findings:

  • Liver biopsies revealed intense cholestasis with minimal portal tract inflammation.

Related Experiment Videos

  • The liver injury demonstrated a prolonged course, persisting up to a year in one patient despite methimazole withdrawal.
  • All patients experienced complete resolution of liver injury following drug cessation.

    • Implications:

    • Methimazole should be considered a potential cause of drug-induced cholestatic jaundice.
    • Monitoring liver function is crucial for patients on methimazole therapy.
    • Understanding the prolonged nature of methimazole-induced liver injury aids in patient management and prognosis.