Hepatotoxicity from Antithyroid Drugs

Vitug, Angelica C.; Goldman, Joel M.

doi:10.1159/000180054

Cited by 63 publications

(38 citation statements)

References 8 publications

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“…Increase of alanine aminotransferase concentrations occurred in 3 of 22 patients taking propylthiouracil compared with none of the patients taking carbimazole. This suggests that propylthiouracil is more hepatotoxic than carbimazole, as reported earlier (30).…”

Section: Discussionsupporting

confidence: 82%

Predictors of outcome and comparison of different drug regimens for the prevention of relapse in patients with Graves' disease

Nedrebø¹,

Holm²,

Uhlving³

et al. 2002

European Journal of Endocrinology

119

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Objective: To investigate the effect of different antithyroid drug (ATD) regimens on relapse rates of Graves' disease, and to look for predictors of relapse. Design and Methods: In a prospective two-way factorial randomized clinical trial, 218 patients with Graves' disease were assigned to ATD combined with L-thyroxine (L-T 4 ) or ATD alone for 12 months. After discontinuation of antithyroid therapy, each group was stratified to either 12 months further treatment with L-T 4 or no treatment. Clinical and biochemical assessments were carried out before treatment, after 3 and 6 weeks, and every third month for 12 months. If the patients lacked symptoms of relapse, laboratory tests were performed every third month for the second year, and thereafter annually. Results: The proportion of all patients with relapse was 47.7% 2 years after withdrawal of ATD. There was no difference in relapse rates between the treatment groups (P ¼ 0:217; log-rank test). Smokers had a higher relapse rate than non-smokers (58.4% vs 38.8%, P ¼ 0:009). Patients who were thyrotropin-receptor antibody (TRAb) positive after 12 months of antithyroid therapy had a higher relapse rate than those who were negative (72.5% vs 36.8%, P , 0:0001). Similarly, relapse was more frequent (55.5%) in patients having large goiter compared with subjects with small goiter (36.3%, P ¼ 0:0007). Conclusions: Relapse rates of Graves' disease were independent of ATD regimen whether followed by L-T 4 therapy or not. Smoking, large goiter and presence of TRAb at the end of ATD therapy were strong predictors of relapse.

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Section: Discussionsupporting

confidence: 82%

Predictors of outcome and comparison of different drug regimens for the prevention of relapse in patients with Graves' disease

Nedrebø¹,

Holm²,

Uhlving³

et al. 2002

European Journal of Endocrinology

119

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“…36,37 There is several human cases of PTU-induced hepatotoxicity. 15,[38][39] The mechanism(s) of PTU hepatotoxicity is obscure.…”

Section: Discussionmentioning

confidence: 99%

Propylthiouracil-induced mitochondrial dysfunction in liver and its relevance to drug-induced hepatotoxicity

Jamshidzadeh¹,

Niknahad²,

Heidari³

et al. 2017

Pharm Sci

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“…Thyroid hormones might also have a direct toxic effect on hepatic tissue 6 . A common reason for co-existence of thyrotoxicosis and jaundice is liver injury induced by several medications, including thionamides which are used in the treatment of hypertoxicosis [7][8][9][10] . This was not the case with all our cases as they were not previously diagnosed with thyrotoxicosis and had not received antithyroid medications prior to presentation.…”

Section: Discussionmentioning

confidence: 99%

“…This was not the case with all our cases as they were not previously diagnosed with thyrotoxicosis and had not received antithyroid medications prior to presentation. Increased levels of transaminases have been seen following initiation of thionamides and this usually occurs within the first few months of treatment 10,11 . Occasionally fulminant hepatic failure occurs.…”

Section: Discussionmentioning

confidence: 99%

A report of three cases of jaundice with thyrotoxicosis

Akande¹,

Wo²

2013

Afr H. Sci.

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Background: Jaundice and hepatic dysfunction have been reported in patients with thyrotoxicosis and could be due to different mechanisms. Objective: To describe three cases of jaundice occurring in patients with thyrotoxicosis and to illustrate the importance of early institution of thionamides when indicated. Methods: We present the clinical and laboratory features of three patients presenting within a year with thyrotoxicosis and jaundice and whose clinical conditions improved remarkably following treatment with thionamides. In addition, current literature on the subject is reviewed and summarised. Results: The three patients presented with goitre and jaundice. None of the patients had received blood products, undergone scarification markings or experienced any previous episode of jaundice. Thyroid function tests in the three patients were consistent with a diagnosis of thyrotoxicosis. Liver function tests showed elevated bilirubin and transaminases. All patients improved remarkably following treatment with thionamides. Conclusion: It is important to rule out thyrotoxicosis in patients with jaundice of unknown cause and consider early use of thionamides for treatment of the thyrotoxicosis, if confirmed.

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Hepatotoxicity from Antithyroid Drugs

Cited by 63 publications

References 8 publications

Predictors of outcome and comparison of different drug regimens for the prevention of relapse in patients with Graves' disease

Predictors of outcome and comparison of different drug regimens for the prevention of relapse in patients with Graves' disease

Propylthiouracil-induced mitochondrial dysfunction in liver and its relevance to drug-induced hepatotoxicity

A report of three cases of jaundice with thyrotoxicosis

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