Methimazole-induced cholestatic hepatitis: two cases report and literature review.
Methimazole is commonly prescribed for patients who are thyrotoxic. Cholestatic hepatitis is a rare but serious adverse event which may be associated with interventional therapy. In this case report, we present two Chinese women with cholestatic jaundice due to methimazole treatment. Both patients had a history of hyperthyroidism; initial laboratory studies of liver function were normal and cholestatic hepatitis occurred after treatment with methimazole. Concomitant liver disease, such as viral hepatitis (A, B, C, D, E), autoimmune hepatitis, primary biliary cirrhosis and calculus of bile duct, were excluded. Liver enzyme levels in both patients returned to normal after stopping methimazole therapy and taking hepatoprotective drugs. It is essential that patients are informed about the earliest symptoms of serious adverse effects of antithyroid drugs, such as hepatic toxicity, and that they are advised to stop taking the drug immediately and contact their physician if such symptoms occur.
Department of Emergency, Zhejiang Provincial People's Hospital, Hangzhou, China.
Hai
H
Zou
Department of Nephrology, Lishui Hospital Affiliated to Zhejiang University, Lishui, China.
Lie
L
Jin
Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.|School of The First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
Li-Ren
LR
Wang
Global Medicines Development, AstraZeneca R&D, Alderley Park, United Kingdom.
Martin
M
Braddock
Department of Emergency, Zhejiang Provincial People's Hospital, Hangzhou, China.
Wen-Wei
WW
Cai
Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.|Institute of Hepatology, Wenzhou Medical University, Wenzhou, China.
Ming-Hua
MH
Zheng
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D013956:Antithyroid Agents / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006505:Hepatitis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D041781:Jaundice, Obstructive / Q000139:chemically induced* / Q000188:drug therapy; D008713:Methimazole / Q000009:adverse effects*; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis
D000893:Anti-Inflammatory Agents; D013956:Antithyroid Agents; D008713:Methimazole; D008775:Methylprednisolone
adverse effect; cholestatic hepatitis; methimazole