RESUMO
Hyperthyroidism is one of the most common endocrinology disorders. Treatment can be either pharmacological, surgical or using radioactive iodine. In Europe methimazole is the antithyroid drug of choice because it can be administered in a single daily dose and has a lower risk of adverse reactions. Around 5% of patients taking thionamides can present any of their side effects, which are usually mild. Liver toxicity due to thionamides is very rare, and severe due to propylthiouracil. We present a clinical case of a cholestatic jaundice and acute toxic hepatitis due to methimazole and a cross-reaction with propylthiouracil. Based on this case a review is presented.
Assuntos
Antitireóideos/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Metimazol/efeitos adversos , Idoso , Antitireóideos/uso terapêutico , Administração de Caso , Colestase Intra-Hepática/induzido quimicamente , Feminino , Doença de Graves/tratamento farmacológico , Doença de Graves/cirurgia , Humanos , Metimazol/uso terapêutico , TireoidectomiaRESUMO
El hipertiroidismo es uno de los trastornos endocrinológicos más frecuentes. Su tratamiento actual consiste en fármacos, yodo radiactivo y cirugía. El metimazol es el fármaco antitiroideo de elección en Europa, porque puede administrarse en una sola dosis diaria y por su menor riesgo de efectos secundarios. En un 5% de los pacientes pueden aparecer efectos secundarios por los fármacos antitiroideos, que suelen ser menores. La enfermedad hepática asociada con estos fármacos es excepcional, y es más común y grave en el caso del propiltiouracilo. Presentamos el caso clínico de un paciente con hipertiroidismo, que desarrolló una hepatitis aguda tóxica colestásica tras la administración de metimazol y, posteriormente, una reacción cruzada con propiltiouracilo. Debido a la rareza del caso, nos parece interesante su presentación.
Hyperthyroidism is one of the most common endocrinology disorders. Treatment can be either pharmacological, surgical or using radioctive iodine. In Europe methimazole is the antithyroid drug of choice because it can be administered in a single daily dose and has a lower risk of adverse reactions. Around 5% of patients taking thionamides can present any of their side effects, which are usually mild. Liver toxicity due to thionamides is very rare, and severe due to propylthiouracil. We present a clinical case of a cholestatic jaundice and acute toxic hepatitis due to methimazole and a cross-reaction with propylthiouracil. Based on this case a review is presented
