Propylthiouracyl-induced severe liver toxicity: An indication for alanine aminotransferase monitoring
Open accessAbstract
Propylthiouracyl (PTU)-related liver toxicity is likely to occur in about 1% of treated patients. In case of acute or subacute hepatitis, liver failure may occur in about one third. We report two further cases of PTU-induced subacute hepatitis, in whom the delay between occurrence of liver damage after the initiation of treatment, the underestimation of its severity and the delayed withdrawal of the drug were all likely responsible for liver failure. The high incidence of liver toxicity related to PTU, its potential severity and delayed occurrence after initiation of treatment are in favor of monthly alanine aminotransferase monitoring, at least during the first six months of therapy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
If not recognized, PTU-induced hepatotoxicity can lead to liver failure and death.
“If not recognized, it can lead to liver failure and death (115,157-159).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [158]
Cites
Epidemiology and Individual Susceptibility to Adverse Drug Reactions Affecting the Liver
Larrey, D. G. (2002) · Seminars in Liver Disease · doi:10.1055/s-2002-30105 · Cited by 296 · see citing works
Fifty Years of Experience with Propylthiouracil-Associated Hepatotoxicity: What Have We Learned?
Williams, K. V., Nayak, S., Becker, D. J., Reyes, J., & Burmeister, L. A. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.6.4011 · Cited by 143 · see citing works
Hepatic Injury during Propylthiouracil Therapy in Patients with Hyperthyroidism: A Cohort Study
Liaw, Y., Huang, M.-J., Fan, K.-D., Li, K.-L., Wu, S.-S., & Chen, T.-J. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-118-6-199303150-00005 · Cited by 136 · see citing works
Epidemiology and Individual Susceptibility to Adverse Drug Reactions Affecting the Liver
Larrey, D. G. (2002) · Seminars in Liver Disease · doi:10.1055/s-2002-30101 · Cited by 124 · see citing works
Gunton, J., Stiel, J. N., Caterson, R. J., & McElduff, A. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.1.0013 · Cited by 109 · see citing works
Iagaru, A. H., & McDougall, I. R. (1948) · The Lancet · doi:10.1016/s0140-6736(48)91343-9 · Cited by 101 · see citing works
Kim, H.-J., Kim, B.-H., Han, Y.-S., Yang, I., Kim, K.-J., Dong, S.-H., Kim, H.-J., Chang, Y.-W., Lee, J.-I., & Chang, R. (2001) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.03469.x · Cited by 99 · see citing works
Huang, M. J., Li, K., Wei, J. S., Wu, S. S., Fan, K. D., & Liaw, Y.-F. (1994) · PubMed · Cited by 82 · see citing works
Steenbergen, W. V., Fevery, J., Vos, R. D., Leyten, R., Heirwegh, K. P. M., & de Groote, J. (1989) · Hepatology · doi:10.1002/hep.1840090225 · Cited by 73 · see citing works
Beckett, G. J., Kellett, H. A., Gow, S., Hussey, A. J., Hayes, J. D., & Toft, A. D. (1985) · BMJ · doi:10.1136/bmj.291.6493.427 · Cited by 66 · see citing works
Liver Tests in Hyperthyroidism: Effect of Antithyroid Therapy
Gürlek, A., Çobankara, V., & Bayraktar, M. (1997) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-199704000-00013 · Cited by 65 · see citing works
Hepatotoxicity from Antithyroid Drugs
Vitug, A. C., & Goldman, J. M. (2008) · Hormone Research · doi:10.1159/000180054 · Cited by 63 · see citing works
Fulminant Hepatic Failure Associated with Propylthiouracil
Ruiz, J. K., Rossi, G. V., Vallejos, H. A., Brenet, R. W., Lopez, I. B., & Escribano, A. A. (2003) · Annals of Pharmacotherapy · doi:10.1177/106002800303700213 · Cited by 63 · see citing works
Propylthiouracil-Induced severe hepatitis: A case report and review of the literature
Ichiki, Y., Akahoshi, M., Yamashita, N., Morita, C., Maruyama, T., Horiuchi, T., Hayashida, K., Ishibashi, H., & Niho, Y. (1998) · Journal of Gastroenterology · doi:10.1007/s005350050167 · Cited by 39 · see citing works
Fulminant Hepatitis during Treatment with Propylthiouracil
Eisen, M. J. (1953) · New England Journal of Medicine · doi:10.1056/nejm195311122492007 · Cited by 34 · see citing works
Meyer‐Geßner, M., Benker, G., Olbricht, T., WINDECK, R., Cissewski, K., Reiners, C., & REINWEIN, D. (2008) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/s-2008-1066570 · Cited by 29 · see citing works
Fulminant Hepatic Failure Associated with Propylthiouracil
Ruiz, J. K., Rossi, G. V., Vallejos, H. A., Brenet, R. W., Lopez, I. B., & Escribano, A. A. (2003) · Annals of Pharmacotherapy · doi:10.1345/aph.1a408 · Cited by 29 · see citing works
An unusual presentation of fulminant hepatic failure secondary to propylthiouracil therapy.
Morris, C. V., Goldstein, R. M., Cofer, J. B., Solomon, H. S., & Klintmalm, G. B. G. (1989) · PubMed · Cited by 27 · see citing works
Severe Hepatotoxicity on Beginning Propylthiouracil Therapy
Lock, D. R., & Sthoeger, Z. M. (1997) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-199706000-00020 · Cited by 15 · see citing works
Kontoleon, P., Ilias, Ι., Koutras, D. A., Kontogiannis, D., & Papapetrou, P. D. (2002) · PubMed · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098 · see citing works
The American Thyroid Association and American Association of Clinical Endocrinologists Taskforce on Hyperthyroidism and Other Causes of Thyrotoxicosis, Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., et al. (2011) · Thyroid · doi:10.1089/thy.2010.0417 · Cited by 898 · see citing works
Propylthiouracil, and methimazole, and carbimazole-related hepatotoxicity
Akmal, A., & Kung, J. (2014) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2014.953796 · Cited by 71 · see citing works
Schmidt, F., & Braunbeck, T. A. (2011) · Journal of Thyroid Research · doi:10.4061/2011/376243 · Cited by 61 · see citing works
Propylthiouracil-Induced Acute Liver Failure: Role of Liver Transplantation
Carrion, A. F., Czul, F., Arosemena, L. R., Selvaggi, G., Garcia-Buitrago, M. T., Tekin, A., Tzakis, A. G., Martin, P., & Ghanta, R. K. (2010) · International Journal of Endocrinology · doi:10.1155/2010/910636 · Cited by 38 · see citing works
The management and metabolic characterization: hyperthyroidism and hypothyroidism
Wang, Y., Sun, Y., Yang, B., Wang, Q., & Kuang, H. (2022) · Neuropeptides · doi:10.1016/j.npep.2022.102308 · Cited by 33 · see citing works
Sequeira, E., Wanyonyi, S., & Dodia, R. (2011) · Journal of Medical Case Reports · doi:10.1186/1752-1947-5-461 · Cited by 28 · see citing works
Vickers, A. E. M., Sinclair, J. R., Fisher, R. L., Morris, S. R., & Way, W. G. (2010) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2010.01.017 · Cited by 18 · see citing works
Rosa, M. M., & Dias, T. (2013) · Handbook of clinical neurology · doi:10.1016/b978-0-7020-4087-0.00054-1 · Cited by 16 · see citing works
Blood transcriptomics: applications in toxicology
Joseph, P., Umbright, C., & Sellamuthu, R. (2013) · Journal of Applied Toxicology · doi:10.1002/jat.2861 · Cited by 15 · see citing works
Anti-thyroid drugs in pediatric Graves′ disease
John, M., Sundrarajan, R., & Gomadam, S. (2015) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.152766 · Cited by 17 · see citing works
Li, N., Li, M., Xiu, L., Liao, W., Ren, Y., Liu, H., Chen, S., Chen, F., Yu, X. L., Fan, A., et al. (2022) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2022.115443 · Cited by 11 · see citing works
Acute Liver Failure: A Potential Complication of Antithyroid Medication Use
Chou, C., Wong, R. J., Higgins, J., Perumpail, R. B., & Ahmed, A. (2014) · Digestive Diseases and Sciences · doi:10.1007/s10620-014-3389-7 · Cited by 8 · see citing works
Mohan, V., & Lind, R. (2016) · Journal of Community Hospital Internal Medicine Perspectives · doi:10.3402/jchimp.v6.32369 · Cited by 7 · see citing works
Drug-Induced Liver Injury: A Unique Presentation of Single-Dose Administration of Propylthiouracil
Weissman, S. I., Rajaratnam, N., Qureshi, N., Inayat, F., & Elias, S. (2020) · Journal of Investigative Medicine High Impact Case Reports · doi:10.1177/2324709620951323 · Cited by 5 · see citing works
Diazzi, C., Brigante, G., Rossi, G., & Rochira, V. (2012) · Thyroid · doi:10.1089/thy.2011.0328 · Cited by 4 · see citing works
Hepatitis aguda colestásica por propiltiouracilo
Moral, P. M., Soler, M. R., Franch, N. M., Sánchez-Tello, V. A., Parra, J. T., García, J. P., & Alborch, J. R. C. (2008) · Gastroenterología y Hepatología · doi:10.1157/13125602 · Cited by 3 · see citing works
Propylthiouracil-Induced Toxic Hepatitis --- Report of One Case
Wang, M.-C., Ko, W., Chen, C.-Y., Luan, T.-S., & Ho, C.-H. (2008) · 內科學誌 · doi:10.6314/jimt.2008.19(3).11 · Cited by 2 · see citing works
Current awareness: Pharmacoepidemiology and drug safety
(2007) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1374
- Authors
- Benyounes, M.
- Affiliations
- UCLouvain (BE)
- Corresponding author
- Benyounes, M
- Venue
- World Journal of Gastroenterology
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2006
- Volume
- 12
- Issue
- 38
- Pages
- 6232
- ISSN
- 1007-9327 (ISSN-L)
- PMC
- PMC4088125
- OpenAlex
- W1664924085
- Cited by
- 20
- References
- 20
- Citations by year
- 2022: 2 · 2020: 1 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Gastroenterology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Keywords
- propylthiouracil, drug-induced liver injury, hepatotoxicity, subacute hepatitis, liver failure, antithyroid drugs, drug withdrawal, thyroid dysfunction
- MeSH terms
- Adult, Alanine Transaminase, Female, Humans, Liver, Propylthiouracil, Antithyroid Agents, Liver Failure, Chemical and Drug Induced Liver Injury
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
