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Methimazole-induced cholestatic jaundice in an elderly hyperthyroid patient
Luz S Ramos-Bonner1, Todd H Goldberg, Susan Moyer
1Division of Geriatric Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA. lsrbmd@verizon.net
The American Journal of Geriatric Pharmacotherapy
|November 13, 2007
Summary
Methimazole, a common hyperthyroidism treatment, may cause severe cholestatic jaundice in elderly patients. Symptoms resolved after discontinuing the drug, suggesting a probable association.
Area of Science:
- Endocrinology
- Hepatology
- Clinical Pharmacology
Background:
- Hyperthyroidism is prevalent in the elderly, with antithyroid medications like methimazole being a primary treatment option.
- Methimazole is frequently prescribed for managing hyperthyroidism due to its efficacy.
Observation:
- A 76-year-old female patient developed severe jaundice and itching six weeks after initiating methimazole for hyperthyroidism.
- Laboratory tests revealed elevated liver enzymes and hyperbilirubinemia, indicative of cholestasis.
Findings:
- The patient was diagnosed with methimazole-induced cholestatic jaundice.
- Discontinuation of methimazole led to gradual improvement of jaundice and normalization of bilirubin levels within eight weeks.
Implications:
- This case highlights a probable association between methimazole and severe cholestatic jaundice in elderly patients.
- Clinicians should monitor for liver dysfunction in elderly patients treated with methimazole for hyperthyroidism.
- Early recognition and drug cessation are crucial for managing methimazole-induced hepatotoxicity.
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