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      • 간기능 이상이 동반된 갑상선중독증에서 메티마졸 치료 1예

        이지응ㄴ,김예안,김이경,박영주 순천향대학교 순천향의학연구소 2014 Journal of Soonchunhyang Medical Science Vol.20 No.2

        We report a case of methimazole-induced acute hepatic failure, which occurred 4 days after initiation of drug in a 51-year-old man with hyperthyroidism. Liver function was evaluated before taking methimazole, total bilirubin was 14.2 mg/dL. This finding suggested toxic hepatitis d/t herbal medication or unknown liver disease. He was treated with methimazole with increasing doses from 15 to 45 mg/day, he developed liver failure gradually, despite of suspending methimazole. From the time of admission, his liver function test was abnormal and liver cirrhosis was suspected by liver sonography. With aggravated liver function, he died of renal failure, sepsis of unknown origin and respiratory failure. Fulminant hepatitis rarely occurs in methimazole users, and spontaneous recovery is expected. But this case shows that methimazole-induced hepatotoxicity with possible underlying liver disease could increase the risk of poor outcomes. And in case of continued deterioration of liver function, prompt liver transplatation should be considered.

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