First Case of Methimazole-Induced Cholestatic Jaundice in An Elderly Man with Hyperthyroidism by RUCAM Scale

Methimazole is an anti-thyroid drug that acts mainly via inhibits the enzyme thyroperoxidase. It has been reported that methimazole is widely used and generally well tolerable in patients with hyperthyroidism. In recent years more and more reports were involved in the methimazole caused people's liver damage and most of these literatures were inappropriate disgnosed by Naranjo scale or not quantitative assessment for disgnosis. We describe a case of patient with hyperthyroidism, gastritisand epilepsy who had developed hepatic damage after multiple drugs administration. After a series of examinations, diseases such as hepatitis, infectious mononucleosis et.al were excluded. Because of the diagnostic challenge and Naranjo scale is less sensitivity for rare reaction in liver injury, Feng Yue and Xiaohua Zhou contributed equally to this work methimazole induced cholestatic jaundice hepatitis was first made by the RUCAM scale. After methimazole, was discontinued, her liver enzyme results began to improve. Along with a literature review, we find RUCAM scale not Naranjo scale is important to quantitative assessment drug-induced liver injury include methimazole-induced cholestatic jaundice.