methimazole and Abdominal-Pain

Topics: Abdominal Pain; Antithyroid Agents; Ascites; Atrial Fibrillation; Diagnosis, Differential; Echocardiography, Transesophageal; Electrocardiography; Female; Heart Failure; Humans; Hyperthyroidism; Magnetic Resonance Imaging, Cine; Medication Adherence; Methimazole; Metoprolol; Middle Aged; Paracentesis; Thyroid Function Tests

Topics: Abdominal Pain; Adult; Anti-Inflammatory Agents, Non-Steroidal; Depressive Disorder; Desvenlafaxine Succinate; Drug Synergism; Duloxetine Hydrochloride; Duodenal Ulcer; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Male; Melena; Methimazole; Naproxen; Selective Serotonin Reuptake Inhibitors; Stomach Ulcer

Methimazole (MMI)-induced acute pancreatitis is very rare but severe adverse reaction. A 51-yr-old male developed a high fever, chills, and abdominal pain, two weeks after commencement on MMI for the treatment of Graves' disease. There was no evidence of agranulocytosis, and fever subsided soon after stopping MMI treatment. However, 5 hr after taking an additional dose of MMI, abdominal pain and fever developed again. His symptoms, biochemical, and imaging studies were compatible with acute pancreatitis. After withdrawal of MMI, he showed clinical improvement. This is the first case of MMI-induced acute pancreatitis in Korea. Clinicians should be aware of the rare but possible MMI-induced pancreatitis in patients complaining of fever and abdominal pain.

Topics: Abdominal Pain; Acute Disease; Diagnosis, Differential; Fever of Unknown Origin; Graves Disease; Humans; Male; Methimazole; Middle Aged; Pancreatitis; Treatment Outcome

Topics: Abdominal Pain; Adrenergic beta-Antagonists; Aged; Antithyroid Agents; Bisoprolol; Female; Humans; Methimazole; Muscle Weakness; Thyroid Crisis

We report a case of hepatotoxicity induced by methimazole treatment in a patient affected by hyperthyroidism. A 54-year-old man, presented to our observation for palpitations, excessive sweating, weakness, heat intolerance and weight loss. On physical examination, his blood pressure was 140/90 mmHg and heart beat was 100/min regular. He had mild tremors and left exophthalmos. Laboratory test revealed a significant increase in serum thyroid hormone levels with a decrease in thyroid stimulating hormone levels. A diagnosis of hyperthyroidism was made and he began treatment with methimazole (30 mg/day). Fourteen days later, he returned for the development of scleral icterus, followed by dark urine, and abdominal pain in the right upper quadrant. Laboratory examinations and liver biopsy performed a diagnosis of cholestatic hepatitis, secondary to methimazole usage. Methimazole was promptly withdrawn and cholestyramine, ursodeoxycholic acid, and chlorpheniramine were given. After five days, abdominal pain resolved and laboratory parameters returned to normal. Naranjo probability scale indicated a probable relationship between hepatotoxicity and methimazole therapy. In conclusion physicians should be aware the risk of hepatotoxicity related with methimazole.

Topics: Abdominal Pain; Antithyroid Agents; Biopsy; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Humans; Hyperthyroidism; Male; Methimazole; Middle Aged; Scleral Diseases

Topics: Abdominal Pain; Adolescent; Constipation; Humans; Male; Methimazole; Thyrotoxicosis