A case report of hyperthyroidism with intolerance of oral medication with methimazole cream

doi:10.3969/j.issn.1674-8115.2024.03.016

Abstract

Abstract:

An elderly male patient sought medical attention due to "intolerance of methimazole tablet and radioiodine treatment for six months". There was a contradiction between the efficacy and adverse drug reaction. Based on the patient′s wishes, the clinical treatment of methimazole cream was adopted. During the follow-up of 12 weeks, the patient′s symptoms were significantly improved, the indicators of thyroid function declined to normal level, and there were no significant abnormalities in indicators for routine blood test and liver function. The case broke away from conventions in medication selection, showing that the initial and reduced dosage was explored and formulated by combination of the theoretical basis of pharmacodynamics, pharmacokinetics and physician′s clinical experience. It also provided clinical reference for the use of the topical formulation.

Key words: methimazole cream, hyperthyroidism, granulocytopenia

CLC Number:

R581.1

XU Ting, ZHANG Yuwen. A case report of hyperthyroidism with intolerance of oral medication with methimazole cream[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(3): 412-416.

Figures/Tables 5

TrendMD

References 9

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Indicator	Value
Routine blood test
WBC/(×10⁹·L^-1)	3.7
NE#/(×10⁹·L^-1)	2.4
Liver function
ALT/(U·L^-1)	31
AST/(U·L^-1)	28
ALP/(U·L^-1)	138
GGT/(U·L^-1)	74
DBIL/(μmol·L^-1)	11.2
Thyroid function
FT3/(mol·L^-1)	28.4
FT4/(pmol·L^-1)	47.8
TSH/(μIU·mL^-1)	<0.01

Indicator	Value
Routine blood test
WBC/(×10⁹·L^-1)	3.7
NE#/(×10⁹·L^-1)	2.4
Liver function
ALT/(U·L^-1)	31
AST/(U·L^-1)	28
ALP/(U·L^-1)	138
GGT/(U·L^-1)	74
DBIL/(μmol·L^-1)	11.2
Thyroid function
FT3/(mol·L^-1)	28.4
FT4/(pmol·L^-1)	47.8
TSH/(μIU·mL^-1)	<0.01

Item	0th week	4th week	27th week
FT3/(mol·L^-1)	8.31	18.20	14.07
FT4/(pmol·L^-1)	26.77	38.12	22.56
TSH/(μIU·mL^-1)	<0.0083	<0.0083	<0.0083
TRAb/(IU·L^-1)	39.0	36.7	34.8
TSI/(IU·L^-1)	>40	>40	>40

Item	0th week	4th week	27th week
FT3/(mol·L^-1)	8.31	18.20	14.07
FT4/(pmol·L^-1)	26.77	38.12	22.56
TSH/(μIU·mL^-1)	<0.0083	<0.0083	<0.0083
TRAb/(IU·L^-1)	39.0	36.7	34.8
TSI/(IU·L^-1)	>40	>40	>40

Item	0th week	4th week	8th week	12th week
FT3/(mol·L^-1)	14.07	3.05	4.24	3.61
FT4/(pmol·L^-1)	22.56	7.73	10.29	10.37
TSH/(μIU·mL^-1)	<0.0083	<0.0083	0.0102	0.0401
TRAb/(IU·L^-1)	34.8	33.0	34.2	33.2
TSI/(IU·L^-1)	>40	>40	>40	37.2