Methimazole-Induced Leukocytoclastic Vasculitis: A Case Report
Weeratian Tawanwongsri1, Pamela Chayavichitsilp1
1Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Case Reports in Dermatology
|November 26, 2019
Summary
Methimazole (MMI), a rare cause of leukocytoclastic vasculitis, was identified in a Thai patient. Discontinuing MMI led to rapid rash resolution, highlighting early drug cessation as key for managing this condition.
Area of Science:
- Endocrinology
- Dermatology
- Pharmacology
Background:
- Leukocytoclastic vasculitis (LCV) is typically linked to infections or medications.
- Antithyroid drugs, particularly methimazole (MMI), are infrequently associated with LCV.
Observation:
- A 41-year-old Thai female with Graves' disease developed LCV after MMI treatment.
- The patient presented with characteristic skin rashes on both legs.
Findings:
- Discontinuation of MMI and administration of cholestyramine resulted in rapid resolution of LCV symptoms within one week.
- Thyroid function remained abnormal, necessitating radioiodine ablation for definitive Graves' disease management.
- No recurrence of skin lesions or systemic involvement was observed during a 3-month follow-up.
Implications:
- Early identification and cessation of the offending drug are paramount in managing drug-induced LCV.
- Immunosuppressive agents may not be required for mild LCV cases without vital organ involvement.
- This case underscores the importance of considering MMI as a potential cause of LCV in clinical practice.
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