{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T17:51:48Z","timestamp":1789408308182,"version":"build-2803163510"},"reference-count":41,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019779","name":"Qatar National Library","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Antithyroid drugs (ATDs) are the cornerstone of hyperthyroidism management. Hepatotoxicity due to ATDs can range from mild transaminase elevation to liver transplantation requirement and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The primary objective of the systematic review was to assess the clinical characteristics and outcomes of patients with drug induced liver injury (DILI) due to ATDs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a systematic review of PUBMED, SCOPUS, and EMBASE on characteristics and outcomes of adults (&amp;gt;18 years) with DILI due to ATDs. We defined DILI as bilirubin \u22652.5\u2005mg\/dL or international normalized ratio &amp;gt;1.5 with any rise in alanine aminotransferase (ALT), aminotransferase (AST), or alkaline phosphatase (ALP), or an elevation of ALT or AST &amp;gt;5 times or ALP &amp;gt;2 times the upper limit of normal without jaundice\/coagulopathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The review included 100 articles describing 271 patients; 148 (70.8%) were female (N = 209). Mean age was 42.9 \u00b1 17.2 years. Graves\u2019 disease was the most common indication for ATDs. Carbimazole\/methimazole (CBM\/MMI) was the most common offending agent (55.7%). DILI pattern was hepatocellular in 41.8%, cholestatic in 41.3%, and mixed in 16.9%. Outcomes included death in 11.8%, liver transplantation in 6.4%, partial improvement in 2.2%, and complete resolution in 79.6% with a median time (IQR) to resolution of 45 (20-90) days. Patients in the propylthiouracil (PTU) group had higher initial bilirubin, initial AST, initial ALT, peak ALT, peak AST, severe and fatal DILI, liver transplantation, and mortality than CBM\/MMI. Rechallenge of antithyroid medication was infrequently reported (n = 16) but was successful in 75%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>DILI due to ATDs can present with different patterns and should prompt immediate drug discontinuation. Referral to a hepatologist should be considered if severe as transplantation is sometimes required. PTU-induced DILI may have worse outcomes than CBM\/MMI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvad133","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T20:24:02Z","timestamp":1698265442000},"source":"Crossref","is-referenced-by-count":12,"title":["Clinical Characteristics and Outcomes of Patients With Antithyroid Drug\u2013Related Liver Injury"],"prefix":"10.1210","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1583-1539","authenticated-orcid":false,"given":"Adeel Ahmad","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Hamad Medical Corporation , 3050, Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fateen","family":"Ata","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hamad Medical Corporation , 3050, Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afia","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation , 3050, Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Elamin","sequence":"additional","affiliation":[{"name":"National University-Sudan , Khartoum 11115 , Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aamir","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tower Health , West Reading, PA 19611 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohaib","family":"Yousaf","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tower Health , West Reading, PA 19611 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Donato","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tower Health 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