Hepatotoxicity and Anti-Nuclear Antibody Positivity During Methimazole Therapy for Thyrotoxicosis: A Case Report
Bibliographic record
Abstract
Thyrotoxicosis is one of the most frequent endocrine disorders. Methimazole is the anti-thyroid drug for the treatment of hyperthyrodism. Methimazole is rarely associated with hepatic toxicity. We reported a case of 56-year-old woman who developed hepatotoxicity and anti-nuclear antibody positivity during methimazole treatment. Increased liver enzyme levels appeared after 1 month of the methimazole treatment. Viral hepatitis markers were negative. The radiological examinations were normal. According to the CIOMS/RUCAM scale, the score was 11 and the causal relationship of the hepatic adverse reaction by methimazole was highly probable. Methimazole-induced hepatotoxicity was considered and methimazole treatment was cancelled. The laboratory parameters returned to normal after 15 days. The mechanism of hepatotoxicity due to methimazole treatment was not fully understood. It has been hypothesized that there is a genetic predisposition, associated with a dose-dependent immune reaction. In conclusion, physicians should be aware the risk of hepatotoxicity related with methimazole treatment. J Med Cases. 2015;6(1):30-32 doi: http://dx.doi.org/10.14740/jmc2009w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".