[Propylthiouracil-induced overt hepatic injury in patients with hyperthyroidism].
OBJECTIVE
To study the incidence, clinical features and related factors of propylthiouracil (PTU)-induced hepatic injury in patients with hyperthyroidism.


METHODS
A prospective study were carried out in 70 patients of hyperthyroidism with normal liver function. Every patient was treated with PTU 300 mg/d until the thyroid functions recovered to normal, following by decease and maintenance PTU dose in period of six months. Liver function, including serum levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), total bilirubin (TBIL) and direct bilirubin (DBIL), thyroid function (serum thyroxine, triiodothyronine, free thyroxine, and free triiodothyronine and thyrotropin) and blood routine items were measured before therapy and once a month for six months after PTU therapy was begun.


RESULTS
Sixty-four cases of 70 patients completed the therapy for 6 months. Hepatic injury developed in 33 patients (51.6%). Asymptomatic, transient hepatic injury was shown in 22 patients (34.4%). Slight symptomatic hepatic injury occured in 6 cases (9.4%) and overt hepatic injury in 5 patients (7.8%) after PTU administration. However, all the patients who developed overt hepatic injury did not stop PTU. Hepatic function returned normal one month after stopping PTU. No one finally suffered from viral hepatitis and autoimmune hepatitis in patients of symptomatic and overt hepatic injury.


CONCLUSIONS
PTU-induced symptomatic hepatic injury is not rare and usually develops within the first few months of PTU administration. Its clinical course is relatively benign. However, it may be difficult to predict its development, so all patients should be monitored for liver function test during the administration in early stage.
Lian
Xiao-lan
XL
Department of Endocrinology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China. lianlanx@Public.bta.net.cn
Bai
Yao
Y
Dai
Wei-xin
WX
Guo
Zhi-sheng
ZS
Li
Wei
W
Lu
Lin
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008107:Liver Diseases / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies
D013956:Antithyroid Agents; D011441:Propylthiouracil