A case of methimazole-induced acute hepatic failure in a patient with chronic hepatitis B carrier.
We report a case of methimazole-induced acute hepatic failure, which occurred 17 weeks after initiation of the drug in a 43-year-old man with hyperthyroidism and hepatitis B surface antigenemia. Postmortem needle autopsy of the liver revealed an established micronodular cirrhosis secondary to hepatitis B with moderate septal/portal inflammation, marked cholestasis and scattered acidophilic bodies. The serum hepatitis B surface antigen (HBsAg) was positive, but reactivation of hepatitis B was unlikely in view of the absence of a serum hepatitis B e antigen (HBeAg) and hepatitis B virus deoxyribonucleic acid (HBV-DNA) and negative stain for HBsAg and hepatitis B core antigen (HBcAg) in the liver tissue.
Kang
H
H
Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea.
Choi
J D
JD
Jung
I G
IG
Kim
D W
DW
Kim
T B
TB
Shin
H K
HK
Kim
B T
BT
Park
C K
CK
Yoo
J Y
JY
D000208:Acute Disease; D000328:Adult; D002353:Carrier State; D056486:Chemical and Drug Induced Liver Injury; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D008297:Male; D008713:Methimazole / Q000009:adverse effects*
D008713:Methimazole