propylthiouracil and Liver-Cirrhosis

Topics: Adrenal Cortex Hormones; Azathioprine; Chronic Disease; Colchicine; Hepatitis; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Cirrhosis, Biliary; Penicillamine; Propylthiouracil; Vidarabine

Alcoholic hepatitis is defined by histological findings, i.e. Mallory bodies, necrosis and polynuclear infiltration. It may be accompanied by steatosis and more or less advanced fibrosis. The clinical picture is variable, ranging from a total absence of symptoms to high fever, jaundice and encephalopathy. Laboratory findings reveal high polynuclear white cell counts, SGOT (but not SGPT) and glutamate dehydrogenase levels. The prognosis varies according to the series studied. The pathogenesis is unclear but cellular and humoral immunity mechanisms may play a role. Therapeutic possibilities are limited, corticosteroids only being useful in very serious cases. Alcoholic hepatitis is not a nosological entity but an acute inflammatory reaction of the liver due to cell necrosis caused by alcohol, and can therefore occur at any stage of alcoholic liver.

Topics: Adult; Aspartate Aminotransferases; Fatty Liver; gamma-Glutamyltransferase; Hepatitis, Alcoholic; Humans; Liver Cirrhosis; Male; Nutrition Disorders; Propylthiouracil; T-Lymphocytes

Topics: Aging; Animals; Dexamethasone; Fasting; Humans; Hyperthyroidism; Hypothyroidism; Infant, Newborn; Kinetics; Liver Cirrhosis; Propylthiouracil; Thyroid Gland; Thyrotropin; Thyroxine; Triiodothyronine

To report a case of propylthiouracil-induced hepatic damage.. A 64-year-old white woman with hyperthyroidism received propylthiouracil 250 mg/d for 1 year. She developed hepatitis after 1 year of therapy. Alcohol and drug abuse were ruled out and all serologic tests for hepatitis A, B, and C were negative. Cytomegalovirus and Epstein-Barr virus infection were also ruled out. Antinuclear antibody, antimitochondrial antibody, and antismooth muscle antibody were negative. The clinical picture was similar to that of viral hepatitis characterized by nausea, vomiting, and jaundice. Histologic examination of a liver biopsy specimen showed chronic active hepatitis. The patient developed cirrhosis during follow-up.. Propylthiouracil is widely used in the treatment of hyperthyroidism. Despite its widespread use, there have been only a few reported cases of propylthiouracil-induced hepatotoxicity. The precise mechanism of the injury is unknown, although immunologic factors are suggested.. Hepatic damage induced by propylthiouracil is a rare complication. However, the danger of permanent hepatic damage should be kept in mind. The best way of preventing propylthiouracil hepatotoxicity is careful screening of patients considered for treatment.

Topics: Antithyroid Agents; Chemical and Drug Induced Liver Injury; Female; Humans; Hyperthyroidism; Liver; Liver Cirrhosis; Middle Aged; Propylthiouracil

Two cases of propylthiouracil-induced liver damage have been observed. The first case is of an acute type of damage, proven by rechallenge; the second presents a clinical and histologic picture resembling chronic active hepatitis, with spontaneous remission.

Topics: Adult; Chemical and Drug Induced Liver Injury; Female; Graves Disease; Humans; Hyperthyroidism; Liver; Liver Cirrhosis; Middle Aged; Propylthiouracil