Turkiye Klinikleri Journal of Case Reports

Efficacy of N-acetylcysteine Treatment in Methimazole-induced Myopathy and Toxic Hepatitis
Tahir BURANa, Mustafa ŞAHİNb, Elmas KASAPa, Semin AYHANc, Burcu ALMACAN İNCEb
aDepartment of Gastroenterology, Manisa Celal Bayar University Faculty of Medicine, Manisa, TURKEY
bDepartment of Internal Medicine, Manisa Celal Bayar University Faculty of Medicine, Manisa, TURKEY
cDepartment of Pathology, Manisa Celal Bayar University Faculty of Medicine, Manisa, TURKEY
Turkiye Klinikleri J Case Rep. 2020;28(4):266-71
doi: 10.5336/caserep.2020-77783
Article Language: EN
Full Text
ABSTRACT
 Today, antithyroid drugs are widely used in the treatment of hyperthyroidism. Elevated creatine kinase and liver injury (hepatitis) caused by methimazole are some of rare side effects. Elevation of creatine kinase (CK) should be monitored due to the risk of rhabdomyolysis development. Also, drug-induced liver injury can be seen. In this article, we report a patient who received methimazole 2 months ago for hyperthyroidism, but then began to have complaints like muscle pain, jaundice (icterus) in the eyes along with itching and dark urine, and found out to have elevated CK as well as liver enzymes induced by liver injury, thus showed rapid recovery upon N-acetylcysteine treatment.

Keywords: Hyperthyroidism; myalgia; creatine kinase; liver injury; icterus
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