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Case Reports
. 2013 May 25;7(2):240-4.
doi: 10.1159/000351877. Print 2013 May.

Acute liver failure associated with propylthiouracil in a pregnant 26-year-old woman

Tatsuo Miyamura  1 , Tatsuo Kanda, Shoko Minemura, Masato Nakamura, Shingo Nakamoto, Xia Jiang, Shuang Wu, Shin Yasui, Makoto Arai, Osamu Yokosuka
Affiliations
Case Reports

Acute liver failure associated with propylthiouracil in a pregnant 26-year-old woman

Tatsuo Miyamura et al. Case Rep Gastroenterol. .

Abstract

It seems appropriate to use propylthiouracil to treat maternal hyperthyroidism during the first trimester of pregnancy. We present the case of a 26-year-old woman with acute liver failure associated with propylthiouracil during the first trimester of pregnancy. She was successfully treated without liver transplantation. Attention should be paid to the possible occurrence of propylthiouracil-induced hepatotoxicity even during the first trimester of pregnancy.

Keywords: Acute liver failure; First trimester; Immune tolerance; Pregnancy; Propylthiouracil.

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Figures

Fig. 1
Fig. 1
Chart describing the course of ALT (black squares) and total bilirubin (black triangles) from the commencement of PTU administration until 1 week after discharge. ALT levels peaked at 531 IU/l. The total dose of PTU was 5,700 mg before admission. The patient improved after stopping PTU.
Fig. 2
Fig. 2
Liver biopsy showed normal architecture of the liver and no cirrhosis (hematoxylin and eosin; original magnification 40×) (a). Centrilobular necrosis was also found (hematoxylin and eosin; original magnification 200×) (b). We diagnosed the patient as drug-induced liver injury associated with PTU.
See this image and copyright information in PMC

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