The Korean Journal of Medicine

  • 제83권3호
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  • Pages.363-368
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  • 2012
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Methimazole 복용 후 발생한 간부전으로 간이식을 시행 받은 1예

A Case Report of Methimazole-Induced Acute Liver Failure Successfully Treated with Liver Transplantation

  • 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)
  • 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)
  • 발행 : 2012.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

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.

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.

키워드

참고문헌

  1. Gallelli L, Staltari O, Palleria C, De Sarro G, Ferraro M. Hepatotoxicity induced by methimazole in a previously healthy patient. Curr Drug Saf 2009;4:204-206. https://doi.org/10.2174/157488609789006912
  2. Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid 2011;21: 593-646. https://doi.org/10.1089/thy.2010.0417
  3. Kang H, Choi JD, Jung IG, et al. A case of methimazoleinduced acute hepatic failure in a patient with chronic hepatitis B carrier. Korean J Intern Med 1990;5:69-73.
  4. Baker B, Shapiro B, Fig LM, Woodbury D, Sisson JC, Beierwaltes WH. Unusual complications of antithyroid drug therapy: four case reports and review of literature. Thyroidology 1989;1:17-26.
  5. Epeirier JM, Pageaux GP, Coste V, et al. Fulminant hepatitis after carbimazole and propranolol administration. Eur J Gastroenterol Hepatol 1996;8:287-288. https://doi.org/10.1097/00042737-199603000-00018
  6. Russo MW, Galanko JA, Shrestha R, Fried MW, Watkins P. Liver transplantation for acute liver failure from drug induced liver injury in the United States. Liver Transpl 2004;10:1018-1023. https://doi.org/10.1002/lt.20204
  7. Mikhail NE. Methimazole-induced cholestatic jaundice. South Med J 2004;97:178-182. https://doi.org/10.1097/01.SMJ.0000054690.98272.B1
  8. Blom H, Stolk J, Schreuder HB, von Blomberg-van der Flier M. A case of carbimazole-induced intrahepatic cholestasis: an immune-mediated reaction? Arch Intern Med 1985;145: 1513-1515. https://doi.org/10.1001/archinte.1985.00360080195029
  9. Zhang M, Zhou H, He R, Di F, Yang L, Yang T. Steroids for the treatment of methimazole-induced severe cholestatic jaundice in a 74-year-old woman with type 2 diabetes. Endocrine 2010;37:241-243. https://doi.org/10.1007/s12020-009-9305-9
  10. Lee KY, Lee YJ, Hong SH, et al. Hepatic injury during treatment with antithyroid drugs in patients with hyperthyroidism. J Korean Soc Endocrinol 2000;15:554-560.
  11. Lee SO, Choi JK, Kim HS, Seo JS, Ahn DS. A case of similar pattern of hepatotoxicity after propylthiouracil and methimazole. Korean J Hepatol 1999;5:136-141.
  12. Kim WS, Kim JH, Yoon BO, et al. A case of methimazoleinduced cholestatic jaundice with steroid therapy. J Korean Soc Endocrinol 1999;14:592-598.
  13. Kang SG, Bae JO, Lee EY, et al. A case of methimazoleinduced cholestatic jaundice with agranulocytosis. J Korean Soc Endocrinol 2005;20:519-523. https://doi.org/10.3803/jkes.2005.20.5.519
  14. Shong YK, Chang YH, Lee KY, Min YI, Lee MH. Prolonged Jaundice after Methimazole administration. J Korean Soc Endocrinol 1990;5:145-148.
  15. Kim DS, Lim TJ, Lee JS, et al. A case of methimzoleinduced cholestatic jaundice. J Korean Soc Endocrinol 1987;2:209-213.

피인용 문헌

  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