Methimazole-induced cholestatic jaundice in an elderly hyperthyroid patient.
Methimazole-induced cholestatic jaundice in an elderly hyperthyroid patient.
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DOI：
10.1016/j.amjopharm.2007.10.003
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发表时间：
2007-09-01
期刊：
影响因子：
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通讯作者：
Anastasopoulou, Catherine
中科院分区：
文献类型：
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作者：
Ramos-Bonner, Luz S;Goldberg, Todd H;Anastasopoulou, Catherine
背景：甲状腺功能亢进症是老年人的常见病。抗甲状腺药物，如甲巯咪唑是为数不多的治疗选择之一。病例总结：一个76岁的白色妇女提出了1周的历史，疲劳，嗜睡，7磅体重减轻，心动过速的诊所。她的血液检查显示促甲状腺激素水平低，游离甲状腺素水平高。由于其症状持续存在，患者住院并开始接受甲巯咪唑10 mg TID治疗。在接受甲巯咪唑治疗甲状腺功能亢进症6周后，她出现严重黄疸和瘙痒。她的肝功能检查结果显示她的碱性磷酸酶和肝转氨酶水平升高，以及主要由结合部分形成的高胆红素血症。诊断为甲巯咪唑引起的胆汁淤积性黄疸。她的症状逐渐改善后，停药，血浆胆红素水平接近正常后8周，没有他巴唑。结论：我们在这里报告一个可能的关联他巴唑使用和严重的胆汁淤积性黄疸的老年甲亢患者。停药后患者黄疸消退。
BACKGROUND: Hyperthyroidism is a common disease in the elderly. Antithyroid medications such as methimazole are one of the few treatment options.CASE SUMMARY: A 76-year-old white woman presented to the clinic with a 1-week history of fatigue, sleepiness, 7-pound weight loss, and tachycardia. Her blood work showed low levels of thyroid-stimulating hormone and high levels of free thyroxine. Due to persistence of her symptoms, she was hospitalized and started on methimazole 10 mg TID. Six weeks after receiving methimazole for the treatment of hyperthyroidism, she had severe jaundice and itching. Results of her liver function tests showed elevation of her alkaline phosphatase and liver transaminase levels, as well as hyperbilirubinemia, formed mainly of the conjugated fraction. Methimazole-induced cholestatic jaundice was diagnosed. Her symptoms gradually improved after discontinuation of the medication, and plasma bilirubin levels were near normal after 8 weeks without methimazole.CONCLUSIONS: We report here a probable association between methimazole use and severe cholestatic jaundice in an elderly hyperthyroid patient. The patient's jaundice was reversed after drug discontinuation.