Hormones combined with methimazole in the treatment of thyroid crisis with hepatitis B and liver failure:a case report
Objective To explore the clinical basis of drug effectiveness and safety in the treatment of hyperthyroidism complicated with liver damage,especially in cases of thyroid crisis with hepatitis B and liver failure.Methods A case of hepatic failure complicated with hyperthyroidism with uncontrolled chronic hepatitis B was reported.The course of treatment was described,including hepatoprotective,enzyme-lowering treatment,artificial liver blood purification,antiviral therapy,and glucocorticoid combined with methimazole therapy after thyroid crisis.Results At admission,the patient's alanine aminotransferase(ALT)was 534.6 U/L,aspartate aminotransferase(AST)was 597.3 U/L,inter-national normalized ratio(INR)was 1.92,and prothrombin activity(PTA)was 30.7%.After hepatoprotective,enzyme-lowering treatment,the INR was 1.94,and PTA was 30.1%.At this time,thyroid crisis occurred,which was dealt with glucocorticoid and methimazole along with antiviral therapy.After treatment,the ALT was 73.3 U/L,AST was 58.2 U/L,INR was 1.26,and PTA was 70.9%.Conclusion For liver failure caused by hyperthyroidism,the use of methimazole is not contraindicated,since treatment of the primary disease of hyperthyroidism is more effective than supportive treatment of liver protection.In case of thyroid crisis complicated with hepatitis B and liver failure,glucocor-ticoid can effectively improve hyperthyroidism and liver injury along with antiviral therapy.
HyperthyroidismThyroid crisisHepatitis BLiver failureMethimazole
NETL
NSTL
万方数据
维普
