{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:31:02Z","timestamp":1787059862110,"version":"build-2736575974"},"reference-count":34,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":93,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Drug-induced pancreatitis represents 1.1% of acute pancreatitis cases. To date, eight cases of antithyroid drug (ATD)-induced pancreatitis have been reported, including seven associated with methimazole (MMI) and one with carbimazole; however, no cases related to propylthiouracil (PTU) have been reported in the literature. We report a patient with thyroid storm who developed acute pancreatitis during MMI therapy, with recurrence following PTU substitution, suggesting cross-reactivity between antithyroid agents. The patient demonstrated elevated serum immunoglobulin G4 (IgG4) concentrations. The clinical presentation and imaging findings (onset during corticosteroid therapy and absence of specific computed tomography findings) supported a diagnosis of drug-induced rather than IgG4-related autoimmune pancreatitis. However, IgG4-mediated autoimmune hyperactivity may predispose to immunological cross-reactions between antithyroid drugs. In patients with MMI-induced pancreatitis and elevated IgG4 levels, PTU cross-reactivity should be anticipated. Alternative therapies, including potassium iodide, radioactive iodine ablation, or thyroidectomy, warrant consideration when immunological dysfunction is suspected based on elevated IgG4 concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-25-0135","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:42:19Z","timestamp":1775558539000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Drug cross-reactivity between methimazole and propylthiouracil causing recurrent pancreatitis in thyroid storm"],"prefix":"10.1530","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2034-3914","authenticated-orcid":true,"given":"Yuriko","family":"Yamazaki","sequence":"first","affiliation":[{"name":"Department of Endocrinology and 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