Successful Outcome with Methimazole and Lithium Combination Therapy for Propylthiouracil-Induced Hepatotoxicity
Abstract
Objective To assess the efficacy and safety of combination therapy with methimazole and lithium carbonate in management of severe thyrotoxicosis and propylthiouracil-induced hepatotoxicity.Methods We present a case report of a patient with severe thyrotoxicosis and worsening liver dysfunction after propylthiouracil therapy, and we review the pertinent literature.Results In a 49-year-old man with severe thyrotoxicosis and propylthiouracil-induced hepatotoxicity, indices of liver function continued to increase despite discontinuation of propylthiouracil treatment. Adjunctive therapy with methimazole and lithium resulted in prompt remission of clinical manifestations and normalization of thyroid hormone indices, as well as a gradual reversal of liver dysfunction.Conclusion Adjunctive therapy with methimazole and lithium is synergistic in promptly achieving a euthyroid state. Therefore, this combination therapy provides a safe and effective alternative option in patients with thyrotoxicosis associated with propylthiouracil-induced hepatotoxicity.
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Except in cases of severe PTU-induced hepatotoxicity, MMI can be used to control thyrotoxicosis without ill effect.
“Except in cases of severe PTU-induced hepatotoxicity, MMI can be used to control the thyrotoxicosis without ill effect (160,161).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [161]
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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
“of severe PTU-induced hepatotoxicity, MMI can be used to control the thyrotoxicosis without ill effect (160,161).”
BackgroundBahn, 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
- Authors
- Waseem, M., Seshadri, K. G., & Kabadi, U. M.
- Affiliations
- John H. Stroger, Jr. Hospital of Cook County (US)
- Corresponding author
- Kabadi, Udaya M.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 1998-07
- Volume
- 4
- Issue
- 4
- Pages
- 197-200
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2057060651
- Cited by
- 15
- References
- 21
- Citations by year
- 2023: 1 · 2018: 1 · 2016: 1 · 2013: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- propylthiouracil, drug-induced liver injury, thyrotoxicosis, methimazole, lithium carbonate, liver dysfunction, euthyroidism
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