Casallo Blanco Sonia, Valero Miguel Angel, Marcos Sánchez Fernando, de Matías Salces Laura, Blanco González José Javier, Martín Barranco María José
Servicio de Medicina Interna, Hospital Nuestra Señora del Prado, Gregorio Corrochano 1, 45600 Talavera de la Reina, Toledo, Spain.
Gastroenterol Hepatol. 2007 May;30(5):268-70. doi: 10.1157/13101979.
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.
甲状腺功能亢进症是最常见的内分泌疾病之一。治疗方法可以是药物治疗、手术治疗或使用放射性碘。在欧洲，甲巯咪唑是首选的抗甲状腺药物，因为它可以每日单次给药，且不良反应风险较低。服用硫代酰胺类药物的患者中约5%可能出现任何副作用，通常较为轻微。硫代酰胺类药物引起的肝毒性非常罕见，丙硫氧嘧啶引起的肝毒性则较为严重。我们报告一例因甲巯咪唑导致胆汁淤积性黄疸和急性中毒性肝炎，并与丙硫氧嘧啶发生交叉反应的临床病例。基于此病例进行了综述。
