CARBIMAZOLE INDUCED CHOLESTATIC HEPATITIS: A CASE REPORT

Dr. Jisha M. Lucca, Muhammed Rashid P. P.*, Rimmon Ninan and Ganesh Chonde

ABSTRACT

Background: Carbimazole, the most commonly used drug to treat the hyperthyroidism. Hepatitis induced by anti thyroid agents is very rare and drug specific. Case report: A 28-year-old unmarried woman presented to the hospital with the complaints of fever, yellowish discolouration of eyes and reduced appetite since 15 days. On examination, her vitals were normal, moderate icterus, bilateral pitting pedal oedema and mild tenderness in the hepatic region observed and negative past history of chronic conditions. Her past medical history revealed that she was a known case of hyperthyroidism and on T.carbimazole 10mg thrice daily for the previous 15 days. She was neither a smoker nor alcoholic and not a drug abuser. Since there was no evident cause for her cholestatic hepatitis apart from the drug, diagnosis of Carbimazole induced hepatitis confirmed. The cholestatic hepatitis was managed by liver protectants along with multi vitamins and hyperthyroidism by lithium, following the withdrawal of the offending drug carbimazole. Conclusion: It is essential for health care professionals to be aware of the importance of monitoring hepatitis and liver function in all patients those who are consuming any type of anti-thyroid drugs especially thionamides.

Keywords: Hyperthyroidism, Thionamide, Carbimazole, Cholestatic hepatitis.