Analysis of 90 cases of antithyroid drug-induced severe hepatotoxicity over 13 years in China
| Autor: | Lin-Fa Li, Yang-Jun Zhu, Jun Yang, Jun Zhang, Meng-Jie Dong, Wan-Wen Weng, Qin Xu |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Drug
Adult Male medicine.medical_specialty China Endocrinology Diabetes and Metabolism media_common.quotation_subject macromolecular substances Gastroenterology Hyperthyroidism Methimazole Young Adult Endocrinology Antithyroid Agents Internal medicine medicine Humans Young adult media_common Aged Retrospective Studies Female to male business.industry Mean age Retrospective cohort study Middle Aged Graves Disease Surgery Thyroxine Treatment Outcome Liver Propylthiouracil Triiodothyronine Female Chemical and Drug Induced Liver Injury Complication business medicine.drug |
| Zdroj: | Thyroid : official journal of the American Thyroid Association. 25(3) |
| ISSN: | 1557-9077 |
| Popis: | 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.Ninety patients with ATD-induced severe hepatotoxicity presenting during a 13 year period (2000-2013) who were about to undergo nuclear medicine therapy with (131)I from a sample of 8864 patients with hyperthyroidism were studied, and the outcomes were evaluated.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 (131)I 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).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. (131)I therapy is an effective treatment approach for patients with ATD-induced severe hepatotoxicity. |
| Databáze: | OpenAIRE |
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