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- Title
Analysis of 90 Cases of Antithyroid Drug-Induced Severe Hepatotoxicity Over 13 Years in China.
- Authors
Yang, Jun; Li, Lin-fa; Xu, Qin; Zhang, Jun; Weng, Wan-wen; Zhu, Yang-jun; Dong, Meng-jie
- Abstract
Background: Antithyroid drug (ATD)-induced severe hepatotoxicity is a rare but serious complication of ATD therapy. The characteristics of severe hepatotoxicity have been reported in only a small number of patients. Method: Ninety patients with ATD-induced severe hepatotoxicity presenting during a 13 year period (2000-2013) who were about to undergo nuclear medicine therapy with 131I from a sample of 8864 patients with hyperthyroidism were studied, and the outcomes were evaluated. Results: The mean age of the patients with ATD-induced severe hepatotoxicity was 41.6±12.5 years (mean±standard deviation), and the female to male ratio was 2.2:1. The methimazole (MMI) dose given at the onset was 19.1±7.4 mg/day. The propylthiouracil (PTU) dose given at the onset was 212.8±105.0 mg/day. ATD-induced severe hepatotoxicity occurred in 63.3%, 75.6%, and 81.1% of patients within 4, 8, and 12 weeks of the onset of ATD therapy, respectively. The types of severe hepatotoxicity did not differ significantly between the MMI and PTU groups ( p=0.188). The frequency of the cholestatic type in the MMI group (35.3%, 18/51) was higher than that in the PTU group (17.9%, 7/39), but these frequencies were not significantly different ( p=0.069). The patients who were treated with 131I received an average dose of 279.1±86.1 MBq ( n=84). Therapy was successful in 60 of the 67 patients (89.6%). The success rate was equivalent ( p=0.696) between the groups receiving MMI (91.7%, 33/36) and PTU (87.1%, 27/31). Conclusions: Severe hepatotoxicity tends to occur within the first three months after the onset of ATD therapy. The type of ATD-induced severe hepatotoxicity did not differ between the MMI and PTU groups. 131I therapy is an effective treatment approach for patients with ATD-induced severe hepatotoxicity.
- Subjects
THYROID antagonists; HEPATOTOXICOLOGY; DRUG side effects; NUCLEAR medicine; HYPERTHYROIDISM; PATIENTS; THERAPEUTICS
- Publication
Thyroid, 2015, Vol 25, Issue 3, p278
- ISSN
1050-7256
- Publication type
Article
- DOI
10.1089/thy.2014.0350