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World J Gastroenterol. Oct 14, 2006; 12(38): 6232-6234
Published online Oct 14, 2006. doi: 10.3748/wjg.v12.i38.6232
Published online Oct 14, 2006. doi: 10.3748/wjg.v12.i38.6232
Propylthiouracyl-induced severe liver toxicity: An indication for alanine aminotransferase monitoring?
M Benyounes, C Sempoux, C Daumerie, J Rahier, AP Geubel, Departments of Gastroenterology, Endocrinology and Pathology, St Luc University Hospital, Université Catholique de Louvain, Brussels 1200, Belgium
Correspondence to: Professor AP Geubel, St Luc University Hospital, 10, Avenue Hippocrate, Brussels 1200, Belgium. geubel@gaen.ucl.ac.be
Telephone: +32-2-7642822 Fax: +32-2-27648934
Received: June 8, 2006
Revised: June 28, 2006
Accepted: July 7, 2006
Published online: October 14, 2006
Revised: June 28, 2006
Accepted: July 7, 2006
Published online: October 14, 2006
Abstract
Propylthiouracyl (PTU)-related liver toxicity is likely to occur in about 1% of treated patients. In case of acute or subacute hepatitis, liver failure may occur in about one third. We report two further cases of PTU-induced subacute hepatitis, in whom the delay between occurrence of liver damage after the initiation of treatment, the underestimation of its severity and the delayed withdrawal of the drug were all likely responsible for liver failure. The high incidence of liver toxicity related to PTU, its potential severity and delayed occurrence after initiation of treatment are in favor of monthly alanine aminotransferase monitoring, at least during the first six months of therapy.