J Korean Med Sci.  2014 Aug;29(8):1170-1173. 10.3346/jkms.2014.29.8.1170.

Acute Pancreatitis Induced by Methimazole Treatment in a 51-Year-Old Korean Man: A Case Report

• Jung JH
• Hahm JR
• Jung J
• Kim SK
• Kim S
• Kim KY
• Kim BR
• Kim HJ
• Jeong YY
• Kim SJ

• KMID: 2129616
• DOI: http://doi.org/10.3346/jkms.2014.29.8.1170

Abstract

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.

Keyword

Methimazole; Graves Disease; Pancreatitis; Drug-Related Side Effects and Adverse Reactions

MeSH Terms

Abdominal Pain/*chemically induced/diagnosis
Acute Disease
Diagnosis, Differential
Fever of Unknown Origin/*chemically induced/diagnosis
Graves Disease/*drug therapy
Humans
Male
Methimazole/*adverse effects/*therapeutic use
Middle Aged
Pancreatitis/*chemically induced/diagnosis
Treatment Outcome
Methimazole

Figure

• 

  Fig. 1 Abdominal computed tomography and ultrasound. (A) Abdominal CT scan showed a swollen pancreas with peripancreatic inflammatory fat stranding, suggestive of acute pancreatitis. (B) Abdominal ultrasound showed no evidence of cholelithiasis and biliary duct dilatation.

• 

  Fig. 2 Clinical course and pancreatic enzyme levels after taking MMI. The right axis shows the levels of pancreatic enzymes, and the left axis shows body temperature. MMI, methimazole; BT, body temperature.

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