title: Factors affecting drug-induced liver injury: antithyroid drugs as instances.
abstract: Methimazole and propylthiouracil have been used in the management of hyperthyroidism for more than half a century. However, hepatotoxicity is one of the most deleterious side effects associated with these medications. The mechanism(s) of hepatic injury induced by antithyroid agents is not fully recognized yet. Furthermore, there are no specific tools for predicting the occurrence of hepatotoxicity induced by these drugs. The purpose of this article is to give an overview on possible susceptibility factors in liver injury induced by antithyroid agents. Age, gender, metabolism characteristics, alcohol consumption, underlying diseases, immunologic mechanisms, and drug interactions are involved in enhancing antithyroid drugs-induced hepatic damage. An outline on the clinically used treatments for antithyroid drugs-induced hepatotoxicity and the potential therapeutic strategies found to be effective against this complication are also discussed.
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Heidari
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ; Pharmacology and Toxicology Department, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Niknahad
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ; Pharmacology and Toxicology Department, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Akram
authors.initials: A
authors.lastname: Jamshidzadeh
authors.affiliation: Pharmacology and Toxicology Department, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Abdoli
mesh_terms: D000818:Animals; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy / Q000209:etiology*; D004195:Disease Models, Animal; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D020011:Protective Agents / Q000627:therapeutic use; D017382:Reactive Oxygen Species / Q000378:metabolism; D012307:Risk Factors
chemical_list: D013956:Antithyroid Agents; D020011:Protective Agents; D017382:Reactive Oxygen Species
keywords: Drug induced liver injury (DILI); Endocrinology; Hepatotoxicity; Idiosyncratic hepatic injury; Risk factors