Carbimazole-induced myositis in the treatment of Graves’ disease: a complication in genetically susceptible individuals?

Lim, Adoree Yi Ying; Kek, Peng Chin; Soh, Abel Wah Ek

doi:10.11622/smedj.2013145

Cited by 11 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In literature, ATDs-related myopathy is rare and mostly involves methimazole (MMZ) and CMZ ( 3 - 9 ), but PTU-related myositis has also been reported ( 10 ). A recent review of these 14 reported cases suggested a possible genetic susceptibility in Asian and female preponderance ( 5 ). Our patient falls in this category.…”

Section: Discussionmentioning

confidence: 99%

“…Management of myopathy varied among reported cases. Dose reduction of MMZ or CMZ ( 4 , 6 , 9 ), cessation of MMZ or CMZ and switching to PTU ( 3 , 5 , 9 ), or addition of levothyroxine ( 4 , 6 - 8 ) had led to resolution of myopathy. The exact pathophysiology of the myopathy is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The exact pathophysiology of the myopathy is unclear. Various mechanisms including direct effect of antithyroid drugs on myocytes, immune-related responses secondary to ATDs and rapid decrements in thyroid hormone has been proposed ( 5 , 6 ). The former two mechanisms rationalize the effectiveness of reducing or stopping current ATDs.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Anti-Thyroid Drugs-Related Myopathy: Is Carbimazole the Real Culprit?

Tsang

Hui

et al. 2014

Int J Endocrinol Metab

View full text Add to dashboard Cite

Introduction:Anti-thyroid drugs (ATDs)-related myopathy is rarely reported in literature, but once developed, it can cause significant morbidity to patient.Case Presentation:A 28-year old Chinese female was treated with carbimazole (CMZ) for Graves’ disease with hyperthyroidism. Two weeks later, she developed myalgia and proximal muscle weakness. Investigations showed evidence of myopathy. CMZ was stopped and rapid improvement of clinical condition and biochemical parameters ensued.Conclusions:Rapid decrement of thyroid hormone level is recognized as an important association for anti-thyroid drugs (ATDs)-related myopathy; however, the drug effects on muscle tissue cannot be excluded. Further elucidation of pathophysiology and identification of risk factors are needed. After commencing ATDs, early recognition of this rare condition and close monitoring are the essence of management. Different treatment strategies: dose reduction of ATDs, switching to alternative ATDs, with or without addition of thyroid hormone supplement can be applied depending on clinical situation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anti-Thyroid Drugs-Related Myopathy: Is Carbimazole the Real Culprit?

Tsang

Hui

et al. 2014

Int J Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…Previous research has found that oral ATDs related myopathy was mostly involved MMI and carbimazole, [ 15 , 16 ] PTU has also been reported. Carbimazole is rarely used in China.…”

Section: Discussionmentioning

confidence: 99%

“…So this side effect may tend to genetic susceptibility. [ 16 ] We should pay more attention to this adverse effect on Chinese GD patients.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional investigation of serum creatine kinase concentration in Graves disease patients treated with oral antithyroid drugs

Cheng¹,

Sun

Zhong³

et al. 2020

Medicine

View full text Add to dashboard Cite

Elevated serum creatine kinase (CK) concentration was reported in some Graves disease patients during the treatment with oral antithyroid drugs (ATD). The pathogenesis of this abnormal biochemical value was considered to be related to the therapeutic drug. However, the relevant epidemiological investigation was absent. Overall, 416 patients with Graves disease treated with oral ATDs were recruited from December 2017 to October 2019. Clinical characteristics such as the patient's medical history and therapeutic regimen were collected. Serum CK concentration and thyroid function were measured. Statistical analysis was adopted to clarify the relationship between serum CK level and these clinical parameters. Elevation of serum CK concentration was emerged in 13.5% patients who were treated with oral ATDs. The proportion was significantly higher among men than among women (19.5% vs 10.8%). There was no correlation between increased serum CK concentration and age. More than 60% of serum CK elevations occurred within 6 months after taking oral ATDs. Free triiodothyronine and free thyroxine are negatively correlated with serum CK concentration. The correlation coefficients are respectively –0.222 ( P < .05) and –0.234 ( P < .05). There is positive correlation between thyroid stimulating hormone and serum CK concentration. The correlation coefficient is 0.405 ( P < .05). There was no statistical correlation between drug dosage and increased serum CK level. Increased serum CK level is a common adverse reaction of oral ATDs. It generally develops early after starting treatment. The cause of this adverse reaction is not clear. It is speculated that elevation of serum CK level is related to the fluctuation of thyroid function.

show abstract

Graves’ Disease

Chng¹

2018

Evidence-Based Endocrine Surgery

View full text Add to dashboard Cite

Carbimazole-induced myositis in the treatment of Graves’ disease: a complication in genetically susceptible individuals?

Cited by 11 publications

References 14 publications

Anti-Thyroid Drugs-Related Myopathy: Is Carbimazole the Real Culprit?

Anti-Thyroid Drugs-Related Myopathy: Is Carbimazole the Real Culprit?

Cross-sectional investigation of serum creatine kinase concentration in Graves disease patients treated with oral antithyroid drugs

Graves’ Disease

Contact Info

Product

Resources

About