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Acute pancreatitis induced by methimazole in a patient with Graves' disease

Mei Yang1, Hua Qu, Hua-Cong Deng

  • 1Department of Endocrinology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.

Thyroid : Official Journal of the American Thyroid Association
|December 6, 2011
PubMed
Abstract

Insights

Methimazole (MMI), used for Graves' disease, can rarely cause acute pancreatitis. This case shows pancreatitis recurring with each MMI exposure, highlighting the need for clinical awareness.

Area of Science:

  • Endocrinology
  • Gastroenterology

Background:

  • Graves' disease is commonly treated with antithyroid drugs like methimazole (MMI).
  • Adverse effects of MMI are known, but acute pancreatitis is a very rare complication.
  • Previous reports of MMI-induced pancreatitis are limited, with few documented cases.

Observation:

  • An 18-year-old female with Graves' disease experienced recurrent episodes of acute pancreatitis.
  • These episodes consistently occurred after MMI administration, four times in total.
  • Symptoms included high fever and upper abdominal pain, with elevated lipase levels observed.

Findings:

  • The patient's symptoms and elevated pancreatic enzymes strongly suggest MMI-induced acute pancreatitis.
  • Resolution of pancreatitis occurred promptly upon discontinuation of MMI.
  • The recurrent nature of the pancreatitis with each MMI exposure supports a causal link.

Implications:

  • MMI-induced acute pancreatitis is a rare but significant adverse effect that can be misdiagnosed.
  • Prompt recognition and cessation of MMI are crucial for managing this condition.
  • Clinicians should maintain awareness of this potential side effect to guide treatment decisions and avoid future MMI exposure.

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