Clin Mol Hepatol.  2014 Sep;20(3):237-248. 10.3350/cmh.2014.20.3.237.

Factors affecting drug-induced liver injury: antithyroid drugs as instances

• Heidari R
• Niknahad H
• Jamshidzadeh A
• Abdoli N

• KMID: 2069759
• DOI: http://doi.org/10.3350/cmh.2014.20.3.237

Abstract

Methimazole and propylthiouracil have been used in the management of hyperthyroidism for more than half a century. However, hepatotoxicity is one of the most deleterious side effects associated with these medications. The mechanism(s) of hepatic injury induced by antithyroid agents is not fully recognized yet. Furthermore, there are no specific tools for predicting the occurrence of hepatotoxicity induced by these drugs. The purpose of this article is to give an overview on possible susceptibility factors in liver injury induced by antithyroid agents. Age, gender, metabolism characteristics, alcohol consumption, underlying diseases, immunologic mechanisms, and drug interactions are involved in enhancing antithyroid drugs-induced hepatic damage. An outline on the clinically used treatments for antithyroid drugs-induced hepatotoxicity and the potential therapeutic strategies found to be effective against this complication are also discussed.

Keyword

Drug induced liver injury (DILI); Endocrinology; Hepatotoxicity; Idiosyncratic hepatic injury; Risk factors

MeSH Terms

Animals
Antithyroid Agents/*adverse effects/chemistry/therapeutic use
Disease Models, Animal
Drug-Induced Liver Injury/drug therapy/*etiology
Graves Disease/drug therapy
Humans
Hyperthyroidism/drug therapy
Protective Agents/therapeutic use
Reactive Oxygen Species/metabolism
Risk Factors
Antithyroid Agents
Reactive Oxygen Species