propylthiouracil and Hepatic-Encephalopathy

The aim of this review was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disease.. Systematic Cochrane Review of randomised clinical trials. The Cochrane Hepato-Biliary Controlled Clinical Trials Register, The Cochrane Library, MEDLINE, and full text searches were combined. All analyses were performed according to the intention-to-treat method. Only randomised clinical trials studying patients with alcoholic steatosis, alcoholic fibrosis, alcoholic hepatitis and/or alcoholic cirrhosis were included. Interventions encompassed propylthiouracil at any dose versus placebo or no intervention. The trials could be double-blind, single-blind or unblinded.. Six randomised clinical trials randomising 710 patients demonstrated no significant effects of propylthiouracil versus placebo on mortality (Peto odds ratio (OR) 0.91, 95% confidence interval (CI) 0.59 to 1.40), liver-related mortality (OR 0.78, CI 0.45 to 1.33), complications to the liver disease (OR 1.14, CI 0.58 to 2.24), and liver histology. Propylthiouracil was associated with a nonsignificant trend toward an increased risk of nonserious adverse events (OR 1.49, CI 0.74 to 2.99) and with the rare occurrence of serious adverse events (leukopenia).. This systematic review could not demonstrate any significant effect of propylthiouracil on any clinically important outcomes (mortality, liver-related mortality, liver complications and liver histology) of patients with alcoholic liver disease.

Topics: Antithyroid Agents; Hepatic Encephalopathy; Humans; Liver Cirrhosis, Alcoholic; Propylthiouracil; Randomized Controlled Trials as Topic; Sensitivity and Specificity; Survival Rate; Treatment Outcome

The poor prognosis of severe acute alcoholic hepatitis has stimulated interest in specific forms of treatment aimed at reducing the short term mortality as well as preventing progression to cirrhosis. Several controlled trials of steroid therapy have suggested an improvement in short-term survival, but the benefit seems to apply to highly selected cases only. Treatment with propylthiouracil and insulin and glucagon infusions has also shown promising results in controlled studies but there is still no general agreement on their value. Despite recent interest in the use of colchicine to prevent progression of cirrhosis in chronic liver disease of other aetiologies, its role in alcoholic liver disease is not yet clear. In end-stage alcoholic cirrhosis, excellent results are now being achieved with liver transplantation, although this is limited to patients who are not alcohol dependent and in whom there is no alcohol-induced extrahepatic disease.

Topics: Amino Acids; Anabolic Agents; Colchicine; Combined Modality Therapy; Hepatic Encephalopathy; Hepatitis, Alcoholic; Humans; Liver Cirrhosis, Alcoholic; Liver Transplantation; Prednisolone; Propylthiouracil

Propylthiouracil (PTU) is the most common antithyroid medication utilized in children for the treatment of hyperthyroidism. An adverse effect of PTU reported infrequently is hepatic injury. The child described here is the fifth reported case of severe hepatic injury in the pediatric age group and documents that clinical or biochemical evidence of hepatic injury requires immediate discontinuation of PTU.

Topics: Chemical and Drug Induced Liver Injury; Child; Exophthalmos; Female; Hepatic Encephalopathy; Humans; Hyperthyroidism; Propylthiouracil

Topics: Adult; Female; Graft Rejection; Graves Disease; Hepatic Encephalopathy; Humans; Liver Transplantation; Lymphoma; Pregnancy; Pregnancy Complications; Propylthiouracil