Propylthiouracil-associated liver failure presenting as probable autoimmune hepatitis in a child with Graves' disease.
This case describes a young girl with Graves' disease, who presented with fulminant hepatic failure 9 months into propylthiouracil (PTU) therapy. Her clinical presentation was consistent with 'probable autoimmune hepatitis,' as defined by the International Autoimmune Hepatitis Group scoring system. Despite discontinuation of PTU and high-dose steroid therapy, she required liver transplantation. Subsequent pathology could not definitively rule out autoimmune hepatitis. PTU is an important cause of drug-related liver failure in children, and clinicians should be mindful that it is frequently used in patients who already have an underlying risk of autoimmune liver disease.
Sipe
Walter E B
WE
Department of Pediatrics, UCSF, San Francisco, CA, USA.
Su
Maureen
M
Posselt
Andrew
A
Kim
Grace E
GE
Quiros
Jose Antonio
JA
Rosenthal
Philip
P
D013956:Antithyroid Agents / Q000627:therapeutic use*; D002102:Cadaver; D002648:Child; D005260:Female; D006111:Graves Disease / Q000188:drug therapy*; D019693:Hepatitis, Autoimmune / Q000209:etiology*; D006801:Humans; D007902:Length of Stay; D017093:Liver Failure / Q000209:etiology* / Q000473:pathology; D016031:Liver Transplantation; D011441:Propylthiouracil / Q000627:therapeutic use*; D016896:Treatment Outcome
D013956:Antithyroid Agents; D011441:Propylthiouracil