[Drug-induced liver failure caused by thiamazole and methimazole--a case report].
Drug-induced liver injury might be responsible for 1 of 600 to 3500 of all hospital admissions. About 2-3% of all drug adverse effects may be connected with the liver. There could be pure injury of heaptic cells or impairment of hepatocellular bile secretion. In our case there was cholestatic liver injury after the use of thiamazole with the complete regression after the discontinuation of the drug. For two years' the patient was treated with methyltiouracyl without any side effects. After 19 years, because of thyreotoxicosis, the methimazole was used. The acute cholestatic liver injury with the high serum bilirubin level (41.4 mg/dl) was observed. Despite the discontinuation of the drug the patient was deceased.


CONCLUSIONS
There are possible cross reactions among imidazolines in patients who are predispose to develop drug-induced liver failure. The doctors should pay much more attention to possible drug side effects.
Sein Anand
Jacek
J
Katedra i Klinika Chorób Wewnetrznych, Geriatrii i Toksykologii Klinicznej, Akademii Medycznej w Gdańsku. jsanand@amg.gda.pl
Chodorowski
Zygmunt
Z
D000368:Aged; D001663:Bilirubin / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced / Q000473:pathology; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D017114:Liver Failure, Acute / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D008111:Liver Function Tests; D008713:Methimazole / Q000009:adverse effects*; D016896:Treatment Outcome
D008713:Methimazole; D001663:Bilirubin