{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:40Z","timestamp":1772168920620,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.149569.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000}},{"DOI":"10.12688\/f1000research.149569.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000}}],"reference-count":12,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>A 56-year-old female with a medical history of unspecified hyperthyroidism and a recent thyroid storm presented to the ED with tachycardia, hypertension, and bilateral enlarged parotid glands. During a previous hospitalization, she was diagnosed with unspecified hyperthyroidism and started on methimazole. During hospitalization, laboratory findings suggested Graves\u2019 disease with an acute thyroid storm. The patient also complained of enlarged parotid glands bilaterally. CT tomography of the neck revealed no calculi of the parotid glands but showed extensive fatty replacement, possibly related to methimazole use. Treatment with propranolol and IV hydrocortisone improved thyroid function. Due to the suspicion of methimazole-induced parotitis, she was transitioned to a reduced methimazole dosage for treatment of Graves\u2019 disease, which subsequently improved her parotitis. Methimazole, the standard initial treatment for Graves\u2019 disease, is generally well-tolerated. It can cause adverse reactions; however, parotitis is very rare and has been documented in only a few case reports. Owing to the limited number of reports, its incidence is currently unknown. Here, we present a case of methimazole-induced parotitis as an unusual presentation of thyroid storm. Drug-induced reactions can only be considered once common causes of parotitis such as viral infection, obstruction, and autoimmune diseases are ruled out. Treatment involves dosage adjustments and supportive care. Methimazole-induced parotitis is often misdiagnosed and overlooked because of the lack of reported cases. This necessitates future research into the reaction mechanisms and optimal treatment.<\/ns3:p>","DOI":"10.12688\/f1000research.149569.3","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T11:30:51Z","timestamp":1743766251000},"page":"447","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Methimazole-Induced Parotitis - An Unusual Presentation"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0088-9572","authenticated-orcid":false,"given":"Ricky","family":"Rana","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Krier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abubakar","family":"Tauseef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jalal","family":"Dufani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1688-1695","DOI":"10.1345\/aph.1R228","article-title":"A review and assessment of drug-induced parotitis.","volume":"46","author":"K Brooks","year":"2012","journal-title":"Ann. Pharmacother."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"255-258","DOI":"10.1111\/j.1365-2710.1993.tb00584.x","article-title":"Drug\u2013induced parotitis.","volume":"18","author":"D Thompson","year":"1993","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"239-245","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions.","volume":"30","author":"C Naranjo","year":"1981","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-22-0031","article-title":"Long-term methimazole therapy in graves\u2019 hyperthyroidism and adverse reactions: A danish multicenter study.","volume":"11","author":"J Karmisholt","year":"2022","journal-title":"Eur. Thyroid J."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"667-670","DOI":"10.1046\/j.1365-2265.1999.00888.x","article-title":"Acute pancreatitis and parotitis induced by methimazole in a patient with graves\u2019 disease.","volume":"51","author":"M Taguchi","year":"1999","journal-title":"Clin. Endocrinol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"bvac038","DOI":"10.1210\/jendso\/bvac038","article-title":"A case of methimazole-induced acute pancreatitis with an HLA allele causing antithyroid drug-induced agranulocytosis.","volume":"6","author":"Y Yoshimura","year":"2022","journal-title":"J. Endocr. Soc."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1001\/jama.1969.03160210056021","article-title":"Parotid gland swelling due to methimazole.","volume":"209","author":"R Moehlig","year":"1969","journal-title":"JAMA."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"941-966","DOI":"10.1016\/S0033-8389(05)70070-1","article-title":"Salivary glands.","volume":"36","author":"A Silvers","year":"1998","journal-title":"Radiol. Clin. North Am."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"4849","DOI":"10.3390\/ijerph20064849","article-title":"Salivary Alterations in Autoimmune Thyroid Diseases: A Systematic Review.","volume":"20","author":"M Ortarzewska","year":"2023","journal-title":"Int. J. Environ. Res. Public Health."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"884-894","DOI":"10.1089\/thy.2020.0715","article-title":"Abnormal Liver Blood Tests in Patients with Hyperthyroidism: Systematic Review and Meta-Analysis.","volume":"31","author":"L Scappaticcio","year":"2021","journal-title":"Thyroid."},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-024-02355-w","article-title":"Thymic hyperplasia is accurate to detect new-onset Graves\u2019 hyperthyroidism and resolves after restoring euthyroidism.","author":"L Scappaticcio","year":"2024","journal-title":"J. Endocrinol. Invest."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"866-872","DOI":"10.1007\/BF03346433","article-title":"Long-term follow-up of patients with hyperthyroidism due to graves\u2019 disease treated with methimazole. comparison of usual treatment schedule with drug discontinuation vs continuous treatment with low methimazole doses: A retrospective study.","volume":"31","author":"E Mazza","year":"2008","journal-title":"J. Endocrinol. Investig."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/13-447\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/13-447\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/13-447\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T13:10:10Z","timestamp":1745586610000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/13-447\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,4]]},"references-count":12,"URL":"https:\/\/doi.org\/10.12688\/f1000research.149569.3","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.149569.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.149569.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.179678.r375574","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.179678.r375575","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.179678.r375574","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,4]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/13-447\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.170633.r317450, Lorenzo Scappaticcio, AOU University of Campania, Naples, 16 Sep 2024, version 2, 1 approved, 1 approved with reservations, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/13-447\/v2#referee-response-317450","order":0,"name":"referee-response-317450","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.170633.r360342, Sumayah Faruq Kasim, Middle Technical University, Baghdad, 23 Jan 2025, version 2, 1 approved, 1 approved with reservations, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/13-447\/v2#referee-response-360342","order":1,"name":"referee-response-360342","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Ricky Rana<\/b>; \n<i>Posted: 19 Mar 2025<\/i>; Thank you for this valuable feedback!&nbsp;We have taken into account your comments and included a more extensive diagnostic workup to exclude other causes and treatment plan in the conclusion section of the paper.&nbsp; We have also added recommendations for patient monitoring and early diagnosis of adverse reactions such as this.","URL":"https:\/\/f1000research.com\/articles\/13-447\/v3#referee-comment-13586","order":2,"name":"referee-comment-13586","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.170633.r360349, T\u00fcrkan Pa\u015fal\u0131 Kilit, Kutahya Health Sciences University Faculty of Medicine, Kutahya, 07 Feb 2025, version 2, 1 approved, 1 approved with reservations, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/13-447\/v2#referee-response-360349","order":3,"name":"referee-response-360349","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.179678.r375574, Jeyakantha Ratnasingam, University Malaya, Kuala Lumpur, 25 Apr 2025, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/13-447\/v3#referee-response-375574","order":4,"name":"referee-response-375574","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}