propylthiouracil and Cholestasis

Aiming to know the incidence and evolution of major adverse reactions to propylthiouracil in patients with hyperthyroidism, we performed a retrospective analysis of 586 patients treated between 1982 and 1992. All known complications associated to the use of propylthiouracil were considered major adverse reactions, when other causes were discarded. Eight patients (1.4% of the sample) had major adverse reactions: three had agranulocytosis, 3 hepatitis, 1 cholestasis and 1 vasculitis. All had a good evolution after discontinuing the drug. The patients with agranulocytosis were treated with antibiotics and the patient with cholestasis received prednisone. We conclude that major adverse reactions to propylthiouracil are infrequent, that they occur preferentially during the first months of treatment, earlier after reexposure and that there was no associated mortality.

Topics: Adolescent; Adult; Agranulocytosis; Chemical and Drug Induced Liver Injury; Cholestasis; Female; Humans; Hyperthyroidism; Male; Middle Aged; Propylthiouracil; Retrospective Studies; Vasculitis

The typical propylthiouracil (PTU)-linked hepatotoxicity, is known to manifest itself by hepatocellular injury with greatly increased serum transaminase values and evidence of hepatic necrosis on liver biopsy. Herewith presented is a 33-year old, thyrotoxic woman who developed cholestatic jaundice two weeks after initiation of PTU therapy. The diagnosis was confirmed by liver biopsy. A causal link between PTU treatment and the cholestatic jaundice was suggested by: the time of onset, typical skin rash and a positive migration inhibition factor (MIF) test to PTU. Awareness of this rare complication of PTU treatment may prevent the performance of unnecessary, expensive and possibly harmful diagnostic procedures.

Topics: Adult; Cholestasis; Female; Humans; Liver; Macrophage Migration-Inhibitory Factors; Methimazole; Propylthiouracil

Topics: Adult; Chemical and Drug Induced Liver Injury; Cholestasis; Female; Humans; Propylthiouracil

Topics: Adult; Cholestasis; Female; Humans; Male; Middle Aged; Propylthiouracil