A Rare Case of Drug Induced Liver Damage by Suspected Additive of Thyradin

Occurrence of thyroxine tablet (Thyradin S^®) - induced liver dysfunction in a patient with subclinical hypothyroidism

“…There are two case reports in the Japanese literature of liver injury suspected due to L-T4 [1,5]. Inui reported a case of allergic hepatitis although the cause of allergy was not clarified [5].…”

“…Inui reported a case of allergic hepatitis although the cause of allergy was not clarified [5]. Toki reported a case of liver dysfunction due to Fe 2 O 3 of Thyradin-S ® [1]. As for the case report, the reason for that Fe 2 O 3 was as the cause of liver dysfunction was the recurrence of liver dysfunction when they changed from Thyradin-S ® include partially pregelatinized starch, corn starch, D-mannitol, Fe 2 O 3, and 3 unlabelled ingredients.…”

Liver dysfunction induced by Levothyroxine Sodium Tablets (Euthyrox®) in a hypothyroid patient with Hashimoto’s thyroiditis: case report and literature review

“…In general, L-T4 is safe and well tolerated by patients at normal dosage. To date and to our knowledge, there has been only six case reports of liver dysfunction induced by administration of L-T4 in a literature search, which are presented in Table 1 [4][5][6][7][8][9]. Drug-induced hepatotoxicity remains a diagnosis of exclusion.…”

“…Therefore, the statement that the mechanism of liver injury is hypersensitivity induced by exogenous administration of L-T4 will need to be further clarified. There are two case reports in the Japanese literature of liver injury suspected due to L-T4 [8,9]. Inui et [4].…”

“…In general, L-T4 is safe and well tolerated by patients, except for the possibility of developing osteoporosis as a result of L-T4 over-replacement, particularly in post-menopausal women, as described in the drug instructions. To our knowledge, liver dysfunction induced by administration of L-T4 has not been reported in China so far, and there are only six case reports all from Japan by searching PubMed [4][5][6][7][8][9]. Recently we encountered a female hypothyroid patient with Hashimoto's thyroiditis, who developed liver injury due to levothyroxine (Euthyrox ® ).…”