Vitug A C, Goldman J M
Horm Res. 1985;21(4):229-34. doi: 10.1159/000180054.
We review the cases of hepatic injury from propylthiouracil, methimazole and carbimazole in the English language literature and compare them to cases of agranulocytosis in a recent review. The data on hepatotoxicity confirm the findings for agranulocytosis that low-dose methimazole is safer than propylthiouracil and that methimazole toxicity is more common over 40 years old. In contrast, propylthiouracil hepatotoxicity often occurs in younger patients. Most cases of hepatic injury occur in the first few months of drug therapy as with agranulocytosis. The reason that methimazole typically causes cholestatic hepatitis while propylthiouracil causes cytotoxic hepatitis remains unknown.
我们回顾了英文文献中丙硫氧嘧啶、甲巯咪唑和卡比马唑所致肝损伤的病例，并将其与近期一篇综述中粒细胞缺乏症的病例进行比较。肝毒性数据证实了粒细胞缺乏症的研究结果，即低剂量甲巯咪唑比丙硫氧嘧啶更安全，且甲巯咪唑毒性在40岁以上人群中更常见。相比之下，丙硫氧嘧啶肝毒性常发生于年轻患者。与粒细胞缺乏症一样，大多数肝损伤病例发生在药物治疗的最初几个月。甲巯咪唑通常导致胆汁淤积性肝炎而丙硫氧嘧啶导致细胞毒性肝炎的原因尚不清楚。
