Pericarditis as the First Sign of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Induced by Methimazole: An Uncommon Onset | Chapter 3 | Medical Science: Updates and Prospects Vol. 4

Background: Thiamazole (Methimazole) is one of the antithyroid drugs (ATDs) that are the most commonly used as first-line therapy in the treatment of thyrotoxicosis due to Graves’ disease and toxic nodular goitre in Tunisia. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) constitutes a group of rare diseases characterised by autoimmune-associated inflammation and vessel damage. AAV can be induced by ATDs, with PTU being more commonly associated with the condition, though it often remains misdiagnosed. Cardiac involvement, particularly pericardial effusion, is uncommon in these cases.

 

Case Report: This chapter reports a case of a 25-year-old woman who had a history of Graves’ disease treated by Methimazole (MMI) 20 mg daily for one year. She was admitted because of pericardial effusion. Two days later, necrotic-looking vasculitic skin lesions appeared. Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) was confirmed by serum test and skin biopsy. The MMI was suspected to be the culprit and was immediately withdrawn. She progressively improves her symptoms, and her skin lesions and pericardial effusion were resolved.

 

Conclusion: Although the association between PTU and AAV is well-documented, less than 1 of 6 ANCA-positive patients treated with ATDs developed AAV. This is the first case report of pericarditis as the first sign of AAV induced by Methimazole. The withdrawal of the offending medication is the fundamental pillar of the therapeutic approach to avoid more severe complications.

 

 

Author(s) Details

Manel Jemel
Department of Endocrinology, National Institute of Nutrition, Tunis, Tunisia and Manar Tunis University, Tunisia.

 

Hanen Sayad
Department of Endocrinology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

 

Ines Khochtali
Department of Endocrinology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v4/6656

A Review on the Role of Berberine in Addition to Methimazole Compare to Methimazole Alone in the Treatment of Graves’ Disease | Chapter 8 | Novel Research Aspects in Medicine and Medical Science Vol. 7

 This unit aim to highlight the function of Berberine in Addition to Methimazole Compare to   Methimazole Alone in the Treatment of Graves’ Disease (GD).  GD is the most coarse form of hyperthyroidism. The disease has a difficult pathophysiology, and autoimmunity is important.  Thyroid-stimulating Hormone (TSH) inundation from the hyperactive thyroid gland is began by antibodies that stimulate the thyrotropin receptor (TRAb).  It has a negative impact on the cardiovascular arrangement, eyesight, cartilages, and other systems during the whole of the body. The affliction is treated accompanying anti-thyroid drugs, radioactive iodine, or thyroid resection, each of which has benefits and disadvantages.  In this chapter, we will examine the newly found function of the gut-thyroid axis in the pathophysiology of GD. The role of the probiotic Berberine increased the anti-thyroid cure Methimazole in modifying the gut microbiota by growing beneficial bacteria and threatening detrimental microorganisms in the gut is described.  Anti-angering cytokines may be raised and inflammatory cytokines may be curbed as a result, that can regulate the immune scheme more quickly and efficiently than with situation with methimazole alone. Through allure impact on the gut-thyroid shaft, this therapy regimen grant permission finally cause the TRAb to disappear more quickly, and GD to go into pause and be cured.

Author(s) Details:

A. Manov,
Sunrise Health Consortium GME, Las Vegas, Nevada, USA.

S. Chauhan,
Sunrise Health Consortium GME, Las Vegas, Nevada, USA.

S. Donepudi,
Sunrise Health Consortium GME, Las Vegas, Nevada, USA.

Please see the link here: https://stm.bookpi.org/NRAMMS-V7/article/view/12160