Liver Injury Induced by Levothyroxine in a Patient with Primary Hypothyroidism
| Autor: | Toshio Fukusato, Takahiro Kawasaki, Masaki Mikami, Makoto Hojo, Taro Ishii, Shinichiro Negoro, Satoko Uegaki, Yoshihiko Morisawa, Atsushi Tanaka, Tomotaka Kawakami, Yasushi Kuyama, Mitsuhiko Aiso, Hajime Takikawa, Takatsugu Yamamoto |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Levothyroxine Immune system Hypothyroidism Internal medicine Internal Medicine Dried thyroid medicine Humans Liver injury Triiodothyronine business.industry Liver Diseases Primary hypothyroidism General Medicine Middle Aged medicine.disease Discontinuation Thyroxine Treatment Outcome Endocrinology Chemical and Drug Induced Liver Injury Lymphocyte stimulation business medicine.drug |
| Zdroj: | Internal Medicine. 46:1105-1108 |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.46.0086 |
| Popis: | We report a patient with primary hypothyroidism, who developed hepatocellular injury due to levothyroxine, synthetic thyroxine. A 63-year-old male was admitted to our hospital due to elevation of liver enzymes. The patient was diagnosed as having hypothyroidism and had been treated with levothyroxine for almost two months until admission. Drug-induced liver injury induced due to levothyroxine was suspected and liver enzymes were rapidly decreased after discontinuation of levothyroxine and dried thyroid powder, also containing thyroxine. Synthetic triiodothyronine, the deiodinated form of levothyroxine was administered instead, and was well tolerated by the patient. The drug-induced lymphocyte stimulation test (DLST) using levothyroxine was negative. Since triiodothyronine which structurally resembles levothyroxine did not cause liver injury, and DLST using levothyroxine was negative, it is unlikely that levothyroxine itself was targeted by the immune system. Rather, we assume that the complex of levothyroxine as the hapten and liver-related macromolecules in the body as the carrier might have acquired antigenicity in this patient and subsequently resulted in liver injury. |
| Databáze: | OpenAIRE |
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