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Methimazole Induced Cholestatic Jaundice: A Case Report
摘要
Background. Hepatic dysfunction and jaundice are sometimes present in patients with hyperthyroidism. They can be clinical manifestations of the disease or the adverse effect of antithyroid medications. Methimazole is widely prescribed for patients with hyperthyroidism. However, cholestatic jaundice is one of the rare but serious adverse events of methimazole therapy. Methods. Here we report a 52-year-old women with Graves' hyperthyroidism who developed cholestatic hepatitis after treatment with methimazole for 4 weeks. Results. The patient clinically revealed hyperbilirubinemia and impaired hepatic function. However, concomitant liver diseases, viral hepatitis A, B and C, cytomegalovirus (CMV) infection, autoimmune hepatitis, IgG 4 related hepatic disease, primary biliary cirrhosis, calculus of bile duct, were excluded with various surveys. The elevated hepatic enzyme returned to normal range after discontinuing methimazole together with conservative treatment observation. Conclusion. Methimazole may cause severe but reversible cholestatic jaundice. It seemed to be uncommon, but the physicians should be precautious for this rare and serious adverse effect.