Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 6, Number 1, January 2015, pages 30-32


Hepatotoxicity and Anti-Nuclear Antibody Positivity During Methimazole Therapy for Thyrotoxicosis: A Case Report

Tables

Table 1. The Laboratory Values Before, During and After the Methimazole Treatment
 
Methimazole pre-treatmentDuring methimazole treatmentMethimazole post-treatment
AST (N: 0 - 34 U/L)1620129
ALT (N: 0 - 49 U/L)1541735
ALP (N: 39 - 155 U/L)326150
GGT (N: 0 - 73 U/L)191,3851,088
Total biluribin (N: 0.3 - 1.2 mg/dL)3.11.07
Direct biluribin (N: 0 - 0.2 mg/dL)2.430.5
Amylase (N: 30 - 130 U/L)4240
WBC (N: 4.6 - 10.2 × 103/μL)8.266.410.5
FT3 (N: 2.3 - 4.2 pg/mL)5.242.372.33
FT4 (N: 0.7 - 1.48 ng/dL)0.80.9
TSH (N: 0.27 - 4.2 mU/L)0.0052.11.78
Anti-TPO (N: 0 - 34 IU/mL)293.6
Anti-Tg (N: 0 - 115 IU/mL)15.1

 

Table 2. CIOMS/RUCAM Scale
 
Type of liver injuryHepatocellularCholestatic/mixedPoints
Score analysis: 0 or lower: relationship with the drug excluded; 1 - 2: unlikely; 3 - 5: possible; 6 - 8: probable; > 8: highly probable.
Time of onset of the eventFirst exposureSecond exposureFirst exposure
Time from drug intake until reaction onset5 - 90 days1 - 15 days5 - 90 days
< 5 or > 90 days> 15 days< 5 or > 90 days
Time from drug withdrawal until reaction onset≤ 15 days≤ 15 days≤ 30 days
Risk factorsAlcoholAlcohol or pregnancy+1
Age ≥ 55 yearsAge ≥ 55 years+1
Course of the reaction> 50% improvement 8 days-+3
> 50% improvement 30 days> 50% improvement 180 days+2
-< 50% improvement 180 days+1
Lack of information or no improvementLack of information or no improvement+0
Worsening or < 50% improvement 30 days--1