CARBIMAZOLE INDUCED CHOLESTATIC HEPATITIS

Thyrotoxicosis is a common disorder especially in women. Most of the patients tolerate antithyroid medications very well with very few developing life threatening side effects. A 64 years old gentleman was diagnosed with hyperthyroidism secondary to Grave’s disease (autoimmune). He was treated with Carbimazole 20 mg daily. With in a month, he presented with acute cholestatic hepatitis. The patient’s symptoms and laboratory abnormalities resolved after withdrawing the offending drug and controlling his thyroid status first with beta blocker and subsequently with propylethioracil. Since the mechanism of liver damage is different, antithyroid medications can be interchanged without increasing the risk of further liver damage.