Jain Karun, Chakrapani M, Smitha K
Department of Orthopedics, JSSMC, Mysore 570 004, India.
Ann Afr Med. 2010 Apr-Jun;9(2):102-4. doi: 10.4103/1596-3519.64752.
Antithyroid drugs have been used for more than 50 years for the management of hyperthyroidism. Most patients tolerate treatment well but some may develop life-threatening side effects such as agranulocytosis, aplastic anemia and cholestatic hepatitis. A 45-year-old female was diagnosed with severe hyperthyroidism. Treatment with Carbimazole 30 mg/day was initiated. Within six weeks following the start of therapy, patient developed potentially life-threatening acute cholestatic hepatitis and agranulocytosis as adverse effects to carbimazole. The patient's symptoms and laboratory abnormalities resolved following withdrawal of offending drug. Agranulocytosis and cholestatic hepatitis together is an extremely rare idiosyncratic side effect of Carbimazole treatment and considered to be dose and age-related. Antithyroid drugs are deceptively easy to use, but because of the variability in the response of patients and the potentially serious side effects, all practitioners who prescribe the drugs need to have a working knowledge of their complex pharmacology.
抗甲状腺药物用于治疗甲状腺功能亢进已有50多年历史。大多数患者对治疗耐受性良好，但有些患者可能会出现危及生命的副作用，如粒细胞缺乏症、再生障碍性贫血和胆汁淤积性肝炎。一名45岁女性被诊断为重度甲状腺功能亢进。开始使用卡比马唑30毫克/天进行治疗。在治疗开始后的六周内，患者出现了可能危及生命的急性胆汁淤积性肝炎和粒细胞缺乏症，作为对卡比马唑的不良反应。停用致病药物后，患者的症状和实验室异常情况得到缓解。粒细胞缺乏症和胆汁淤积性肝炎同时出现是卡比马唑治疗极其罕见的特异质性副作用，被认为与剂量和年龄有关。抗甲状腺药物看似易于使用，但由于患者反应的变异性以及潜在的严重副作用，所有开此类药物的从业者都需要对其复杂的药理学有实际的了解。
