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Methimazole-induced acute pancreatitis: a case report
Itsuka Kikuchi1, Nobuyuki Miyata2, Yukihiro Yoshimura2
1Department of Gastroenterology, Jikei University Hospital, 3-19-18, Nishishimbashi, Minato-ku, Tokyo, Japan. itsutsu103@gmail.com.
Clinical Journal of Gastroenterology
|November 27, 2018
Summary
Methimazole (MMI), used for Graves' disease, can induce acute pancreatitis. This case highlights MMI-induced pancreatitis presenting without abdominal pain, emphasizing the need for consideration of this adverse drug reaction.
Area of Science:
- Endocrinology
- Gastroenterology
- Pharmacology
Background:
- Graves' disease is an autoimmune disorder treated with antithyroid medications.
- Methimazole (MMI) is a common treatment for hyperthyroidism.
- Drug-induced pancreatitis is a known but uncommon adverse effect of various medications.
Observation:
- A 76-year-old woman with Graves' disease developed fever and nausea 19 days after starting MMI and potassium iodide.
- Laboratory tests revealed elevated pancreatic enzymes and C-reactive protein.
- Abdominal CT showed pancreatic swelling, consistent with acute pancreatitis.
Findings:
- The patient's symptoms and laboratory abnormalities resolved after discontinuing MMI.
- This case is the sixth reported instance of MMI-induced pancreatitis and the first without abdominal pain.
- The findings suggest a causal link between MMI and acute pancreatitis.
Implications:
- Clinicians should consider MMI-induced pancreatitis in patients presenting with pancreatic inflammation, even in the absence of abdominal pain.
- Early recognition and MMI discontinuation are crucial for managing this adverse drug reaction.
- Further research may elucidate the precise mechanisms of MMI-induced pancreatitis.
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