1.Lithium as pre-radioablative treatment of Graves’ Disease Complicated by Thyroid Storm and Methimazole-induced Agranulocytosis: A case report
Valerie R. Ramiro ; Jose Paolo P. Panuda ; Cecileen Anne M. Tuazon ; Roland Reuben B. Angeles ; Iris Thiele Isip-Tan
Philippine Journal of Internal Medicine 2022;60(2):143-146
Thyroid storm and thionamide-induced agranulocytosis are both rare and serious medical emergencies. We report a case of a patient in which these two rare events simultaneously occurred. A 33-year-old male, maintained on Methimazole for Graves’ Disease, presented with fever, throat pain, and uncontrolled thyrotoxic symptoms. Methimazole was promptly discontinued. Thyroid storm was alternatively treated with lithium, hydrocortisone, and propranolol. Agranulocytosis was managed supportively with GCSF and empiric antibiotics. Lithium was maintained until after radioablation. When thionamides are contraindicated, lithium is a viable option for the acute management of thyroid storm and a bridge to definitive therapy.
Methimazole
;
Lithium
2.RE: Novel Application of Quantitative Single-Photon Emission Computed Tomography/Computed Tomography to Predict Early Response to Methimazole in Graves' Disease
Wei ZHANG ; Zhuo Qun HUANG ; Wei Long LIN ; Shi Hong YANG
Korean Journal of Radiology 2018;19(1):185-186
No abstract available.
Graves Disease
;
Methimazole
3.Anti-tuberculosis Treatment-Induced Insulin Autoimmune Syndrome.
Jung Suk HAN ; Han Ju MOON ; Jin Seo KIM ; Hong Il KIM ; Cheol Hyeon KIM ; Min Joo KIM
The Ewha Medical Journal 2016;39(4):122-124
Insulin autoimmune syndrome, a rare cause of endogenous hyperinsulinemic hypoglycemia, is characterized by insulin autoantibody, hyperinsulinemia and fasting hypoglycemia. It is well known that drugs containing a sulfhydryl group such as methimazole or α-mercaptopropionyl glycine can induce insulin autoimmune syndrome. However, insulin autoimmune syndrome caused by anti-tuberculosis treatment is very rare. We report a case of insulin autoimmune syndrome after anti-tuberculosis treatment with a review of the relevant literature.
Glycine
;
Hyperinsulinism
;
Hypoglycemia
;
Insulin*
;
Methimazole
;
Tuberculosis
4.A case of Methimazole-Induced Cholestatic Jaundice With Agranulocytosis.
Sang Gu KANG ; Jong Oh BAE ; Eun Young LEE ; Seong Min LIM ; Sang Kun CHO ; Ji Hye KIM ; Sun Kyung SONG
Journal of Korean Society of Endocrinology 2005;20(5):519-523
Methimazole is a widely used and generally well-tolerated antithyroid agent. Adverse reactions occur in 1~5% of patients taking methimazole medication, but these are most commonly transient, benign leukopenia and a skin rash. Severe cholestatic jaundice, combined with agranulocytosis, has been known as a rare complication. Herein, a case of methimazole induced cholestatic jaundice, with agranulocytosis, is reported.
Agranulocytosis*
;
Exanthema
;
Humans
;
Jaundice, Obstructive*
;
Leukopenia
;
Methimazole
6.Aplasia Cutis Congenita in a Baby born to Hyperthyroid Mother Treated with Methimazole During Pregnancy: A Case Report.
Myo Jing KIM ; Mi Jin KIM ; Gyu Rang CHO ; Hee Won CHUEH ; Jin A JUNG ; Young Souk LEE ; Young Hoon KIM ; Jae Ho YOO
Journal of Korean Society of Pediatric Endocrinology 2008;13(1):100-103
Aplasia cutis congenita is a rare congenital anomaly characterized by focal absence of skin at birth. It most commonly manifests as a solitary defect on the scalp, but sometimes it may occur as multiple lesions. Frieden classified aplasia cutis congenita into nine types according to the associated anomalies, but a unifying theory has not been identified to explain the etiology of this disease. We report a case of a newborn with isolated aplasia cutis congenita on the scalp at birth, whose mother was treated with methimazole up to the 22 weeks of gestation due to hyperthyroidism.
Ectodermal Dysplasia
;
Humans
;
Hyperthyroidism
;
Infant, Newborn
;
Methimazole
;
Mothers
;
Parturition
;
Pregnancy
;
Scalp
;
Skin
7.A Case of Agranulocytosis and Soft Tissue Abscess after Increasing Methimazole Dose in a Patient with Graves Disease under Long-term Mainternance Therapy.
Se Yoon PARK ; Sung Wan CHUN ; Yeo Joo KIM ; Sang Jin KIM
Journal of Korean Thyroid Association 2011;4(1):54-57
Antithyroid drugs (ATD) has been widely used to treat Graves' disease. However agranulocytosis, a serious fatal complication of ATD treatment, occurs in about 0.5 percent. The symptoms may mimic viral infections (fever, sore throat), and the potentially life-threatening pyogenic infections can go unrecognized initially. The median duration of drug exposure before the onset of acute agranulocytosis is within 30 days in most cases. We report a case of agranulocytosis with secondary soft tissue infection and abscess occuring after increasing the dose of methimazole in a woman who had taken methimazole for more than 10 years. We administered broad-spectrum antibiotics and aspirated the soft tissue abscess. A review of the medical literature regarding agranulocytosis in the setting of ATDs is presented.
Abscess
;
Agranulocytosis
;
Anti-Bacterial Agents
;
Antithyroid Agents
;
Female
;
Graves Disease
;
Humans
;
Hydrazines
;
Methimazole
;
Soft Tissue Infections
8.Incidence & Prevalence of Hyperthyroidism and Preference for Therapeutic Modalities in Korea.
Gi Hyeon SEO ; Sun Wook KIM ; Jae Hoon CHUNG
Journal of Korean Thyroid Association 2013;6(1):56-63
BACKGROUND AND OBJECTIVES: The incidence and prevalence of hyperthyroidism has been reported to be 0.2-0.9/1000 population/year and 5-10/1000 population in foreign countries, respectively. However, there has been no nationwide survey to evaluate them in Korea. Therefore, this study was conducted to investigate the incidence and prevalence of hyperthyroidism in Korea using medicare claims data provided by the Health Insurance Review and Assessment Service. Preference for its therapeutic modalities and its change were also analyzed. MATERIALS AND METHODS: This study was performed in 308,584 (men 86,460, women 222,124) Korean patients with hyperthyroidism treated from January 2006 to June 2012. Patients with past history of hyperthyroidism were not included. RESULTS: The incidence of hyperthyroidism was 0.72/1000 population/year (men 0.40, women 1.03), and its prevalence was 3.40/1000 population (men 2.09, women 4.70) in Korea. Its peak prevalence was detected between 45 and 49 years of age. Among 177,487 patients with hyperthyroidism treated from 2007 to 2011, anti-thyroid drugs were prescribed in 97.9%, and radioiodine therapy and surgery were finally performed in 8.2% and 0.9%, respectively. The prescription of propylthiouracil (PTU) has been reduced from 63.3% in 2007 to 42.9% in 2011, but the use of methimazole (MMI) increased from 33.9% in 2007 to 54.8% in 2011. Primary physicians preferred PTU to MMI, but physicians in general hospitals preferred MMI to PTU. CONCLUSION: This is the first nationwide report to investigate the incidence and prevalence of hyperthyroidism in Korea.
Female
;
Hospitals, General
;
Humans
;
Hyperthyroidism
;
Incidence
;
Insurance, Health
;
Korea
;
Medicare
;
Methimazole
;
Prescriptions
;
Prevalence
;
Propylthiouracil
9.Acute Onset Methimazole-Induced Arthralgia and Skin Rash.
Kyung Hye PARK ; Jin Hyoung KIM ; Se Eun HAN ; Chan Sung PARK ; Il Sung NAM-GOONG ; Young Il KIM ; Eun Sook KIM
Journal of Korean Thyroid Association 2014;7(1):83-87
Methimazole, a type of thionamide, is used to treat hyperthyroidism. Several adverse effects of thionamides have been reported. The representative minor adverse effects are arthralgia, skin rash, and gastric intolerance. Methimazole is reported to induce 1-6% of arthralgia cases. These patients begin to suffer from arthralgia from 1 month to 2 years after methimazole treatment. Here, we present a patient with acute onset methimazole-induced arthralgia and skin rash. At 2 days after starting methimazole treatment, a 57-year-old female developed arthralgia and a skin rash on her right leg, which subsequently spread to her left leg and right arm, and she stopped taking the medication. The patient was admitted to the rheumatology department of Ulsan University Hospital, where laboratory tests and a skin biopsy were performed to ascertain whether she had a rheumatic disorder. The skin biopsy revealed nonspecific inflammation. At 2 days after stopping methimazole treatment, the arthralgia and skin rashes had improved and methimazole treatment was recommenced. However, the same symptoms developed within 1 day. Therefore, methimazole treatment was again stopped and the symptoms disappeared.
Arm
;
Arthralgia*
;
Biopsy
;
Exanthema*
;
Female
;
Humans
;
Hyperthyroidism
;
Inflammation
;
Leg
;
Methimazole
;
Middle Aged
;
Rheumatology
;
Skin
;
Ulsan
10.Methimazole-Induced Acute Cholestatic Hepatitis in a Patient with History of Simvastatin-Induced Liver Injury.
Mi Kyung KWAK ; So Ra KIM ; Jung Wan PARK ; Su Jung HAN ; Min Jin KIM ; So Young JIN ; Hye Jeong KIM ; Jae Young JANG ; Dong Won BYUN ; Hyeong Kyu PARK
Soonchunhyang Medical Science 2014;20(2):163-167
Methimazole and prophylthiouracil are commonly prescribed for patients with hyperthyroidism. The serious side effect of toxic hepatitis caused by these two drugs is well known. According to recent Korean and American management guidelines for hyperthyroidism, mehimazole is recommended as the first-choice antithyroid drug for the treatment of hyperthyroidism. Toxic hepatitis rarely occurs in methimazole users. We report a rare case of a 52-year-old female with toxic hepatitis after methimazole use that had past medical history of simvastatin induced liver injury.
Drug Interactions
;
Drug-Induced Liver Injury
;
Female
;
Hepatitis*
;
Humans
;
Hyperthyroidism
;
Liver*
;
Methimazole
;
Middle Aged
;
Simvastatin