Diagnosis and treatment principles of liver injury induced by antithyroid drugs / 临床肝胆病杂志

Pharmacotherapy is the primary treatment method for hyperthyroidism. Antithyroid drugs can induce liver injury， and the diagnosis of drug-induced liver injury is mostly exclusive based on medical history collection， clinical symptoms， serum biochemistry， radiological examination， and histology. According to the severity of liver injury， drug-induced liver injury can be classified into mild， moderate， severe， and fatal degrees. Drug withdrawal may not be necessary for patients with mild liver injury， but regular monitoring of liver function is required； in severe cases， patients may develop liver failure， which may lead to a mortality rate， and early identification， timely drug withdrawal， and reasonable pharmacotherapy can help to avoid fatal consequences. The treatment principles of liver injury induced by antithyroid drugs include promoting the recovery of liver injury， preventing the severe exacerbation and chronicity of liver injury， and reducing the risk of death. Standardized medication， timely monitoring， early identification， and early treatment are important measures for the prevention and treatment of liver injury induced by antithyroid drugs.

Clinical Presentations of 36 Cases of Antithyroid Drug-induced Agranulocytosis / 医学研究杂志

Objective In this article,we report and discuss the clinical presentation of antithyroid drug(ATD)-induced agranulocytosis.Methods We retrospectively studied 36 cases of ATD-induced agranulocytosis over the past 14 years in PUMC hospital.Results ATD-induced agranulocytosis patient's age ranged of 16-62 years old.88.9％ of ATD-induced agranulocytosis occured with a large ATD treatment.91.7％ patients occured in the first three month of drug therapy.A case occured agranulocytosis when 8 months duration.94.4％ patients occurs secondary infections.Conclusion This study showed that ATD-induced agranulocytosis considered to be dose dependent,not irrelevant to sex,age and the drug.

Propythiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis:analysis of 6 cases / 中国免疫学杂志

Objective:To improve the knowledge on propythiouracil(PTU)-induced antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis.Methods:6 cases of PTU-induced ANCA-associated vasculitis were analyzed on clinical manifestation,laboratory and biopsy findings,therapy and prognosis.Results:All patients with Grave's disease had been treated with PTU from 2 months to 7 years suffered from ANCA-associated vasculitis, which can also appear after withdrawal of PTU. Clinical manifestations are different with only skin, joint, muscle involvements on mild cases or lung, renal and hematological involvement on severe cases. Sera from all patients were anti MPO-ANCA positive. All patients responded to withdrawal of PTU and administration of prednisone and immuno-suppressants well with ANCA declined or turned to negative.Conclusion:PTU can induce ANCA-associated vasculitis in the part of which lung and kidney can be seriously involved. Early withdrawal of PTU and administration of immunosuppressive agents might improve the prognosis.