The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case Report of Methimazole-Induced Acute Liver Failure Successfully Treated with Liver Transplantation

Methimazole 복용 후 발생한 간부전으로 간이식을 시행 받은 1예

  • Jeon, Sung-Jin (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Kim, Tae-Yong (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Lee, Seung-Hoon (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Kang, Jong-Sik (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Choi, Gwang-Hyeon (Department of Internal Medicine, Ulsan University College of Medicine) ;
  • Lee, Seung-Gyu (Department of Surgery, Ulsan University College of Medicine) ;
  • Hwang, Hee-Sang (Department of Pathology, Ulsan University College of Medicine)
  • 전성진 (울산대학교 의과대학 내과학교실) ;
  • 김태용 (울산대학교 의과대학 내과학교실) ;
  • 이승훈 (울산대학교 의과대학 내과학교실) ;
  • 강종식 (울산대학교 의과대학 내과학교실) ;
  • 최광현 (울산대학교 의과대학 내과학교실) ;
  • 이승규 (울산대학교 의과대학 외과학교실) ;
  • 황희상 (울산대학교 의과대학 병리학교실)
  • Published : 2012.09.01
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Abstract

Antithyroid drugs inhibit the synthesis and excretion of thyroid hormone from the thyroid gland. Propylthiouracil (PTU) and methimazole are well known as antithyroid drugs. In 2011, the American Thyroid Association and American Association of Clinical Endocrinologists published management guidelines for hyperthyroidism and other causes of thyrotoxicosis, and recommended methimazole as the first-choice antithyroid drug for the treatment of hyperthyroidism. Lower hepatotoxicity is an advantage of methimazole. Fulminant hepatitis rarely occurs in methimazole users, and spontaneous recovery is expected even if it does occur. We describe a rare case of acute liver failure after methimazole intake in a 60-year-old man who underwent liver transplantation.

최근 가이드라인을 보면 PTU의 간독성 부작용과 관련하여 갑상선기능항진증 치료로 메티마졸을 사용하도록 권장하고 있다. 그러나 매우 드물지만 메티마졸에 의해서 간독성이 발생할 수 있고, 본 증례처럼 간이식이 필요할 정도로 심각한 간부전을 일으킬 수도 있다. 저자들은 60세 남자 환자가 메티마졸을 복용한 후 간부전이 발생하여 간이식을 시행한 증례를 경험하였기에 문헌고찰과 함께 보고하였다.

Keywords

References

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  1. Carbonyl Traps as Potential Protective Agents against Methimazole‑Induced Liver Injury vol.29, pp.4, 2012, https://doi.org/10.1002/jbt.21682
  2. Exacerbated liver injury of antithyroid drugs in endotoxin-treated mice vol.42, pp.6, 2012, https://doi.org/10.1080/01480545.2018.1459668