Drug-Induced Liver Injury: A Unique Presentation of Single-Dose Administration of Propylthiouracil

Abstract

Antithyroid drug-induced severe liver injury is an uncommon but serious complication. We hereby delineate the case of a 38-year-old female who presented to the emergency department for an impending thyroid storm. After initiation of a single dose of propylthiouracil, her liver enzymes went into the thousands. She was subsequently admitted to the intensive care unit. Propylthiouracil was discontinued and corticosteroids were initiated with the resolution of her elevated liver enzymes. On follow-up, her liver function was at its baseline and thyroid hormone levels were under control. We hope this report will encourage clinicians to cast a broad differential diagnosis in patients presenting with liver injury in the acute setting. Furthermore, it is imperative to raise awareness regarding the ever-increasing list of pharmacologic agents that can perpetuate drug-induced hepatotoxicity.

Drug-induced liver injury associated with liraglutide use: a case-based review of detection, severity, causality assessment, and clinical outcomes

“…+1 0 0 (9) Did the patient have a similar reaction to the same or similar drugs in any previous exposure? +1 0 0 (10) [18]. They described it based on their observation of 35% lymphocyte toxicity (normal, 10-15%) due to liraglutide [18].…”

“…For instance, in our National Inpatient Sample-based retrospective study, we discovered that immunotherapy was linked to a roughly 5-fold increased risk of in-hospital hepatotoxicity when compared to a matched inpatient group [9]. In patients with DILI, prompt cessation of the culprit drug is the cornerstone of clinical management [10]. Moreover, idiosyncratic adverse drug reactions may show a serious clinical course, leading to considerable morbidity or even mortality.…”

“…Moreover, idiosyncratic adverse drug reactions may show a serious clinical course, leading to considerable morbidity or even mortality. Therefore, it is critical to have up-to-date knowledge of drugs that may cause DILI [10].…”

Một trường hợp lâm sàng về nhiễm độc gan do propylthiouracil ở bệnh nhân Graves’

“…Không những thế, hiệu quả của corticosteroid còn được ghi nhận trong viêm gan do methimazole [7]. Đối với bệnh nhân này, sử dụng methylprednisolone 120mg/ ngày đã giúp ngăn cản quá trình hủy hoại tế bào gan với bằng chứng các transaminase máu giảm dần theo thời gian.…”