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Acute Myocarditis Following Methimazole: A Case Report

  • Author Footnotes
    # Drs Li and Yan contributed equally to this work.
    Xiaohui Li
    Footnotes
    # Drs Li and Yan contributed equally to this work.
    Affiliations
    Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Author Footnotes
    # Drs Li and Yan contributed equally to this work.
    Yuerong Yan
    Footnotes
    # Drs Li and Yan contributed equally to this work.
    Affiliations
    Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Maohuan Lin
    Affiliations
    Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Caixia Chen
    Affiliations
    Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Rongxue Yang
    Affiliations
    Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Zhuo Zhang
    Affiliations
    Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Mingtong Xu
    Correspondence
    Address correspondence to: Mingtong Xu, Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Rd, Guangzhou 510120, People's Republic of China.
    Affiliations
    Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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  • Author Footnotes
    # Drs Li and Yan contributed equally to this work.
      Hyperthyroidism is an endocrine disorder characterized by hypermetabolism and increased excitability of multiple organs attributable to improper and excessive synthesis and the secretion of thyroid hormones. Methimazole (MMI), one of the first-line antithyroid drugs, is the preferred drug for hyperthyroidism therapy.
      • Kahaly GJ.
      Management of Graves thyroidal and extrathyroidal disease: an update.
      Long-term antithyroid drug treatment is safe and causes adverse effects in only 3% to 5% of patients.
      • Cooper DS.
      Antithyroid drugs.
      • Azizi F
      • Malboosbaf R.
      Safety of long-term antithyroid drug treatment? a systematic review.
      • Bartalena L
      • Bogazzi F
      • Martino E.
      Adverse effects of thyroid hormone preparations and antithyroid drugs.
      Common adverse reactions to this treatment include rash, itching, joint pain, and transient leukopenia, which are always mild and transient.
      • Cooper DS.
      Antithyroid drugs.
      • Azizi F
      • Malboosbaf R.
      Safety of long-term antithyroid drug treatment? a systematic review.
      • Bartalena L
      • Bogazzi F
      • Martino E.
      Adverse effects of thyroid hormone preparations and antithyroid drugs.
      Other major adverse reactions include agranulocytosis, toxic hepatitis, vasculitis, and drug-induced lupus erythematosus.
      • Cooper DS.
      Antithyroid drugs.
      • Azizi F
      • Malboosbaf R.
      Safety of long-term antithyroid drug treatment? a systematic review.
      • Bartalena L
      • Bogazzi F
      • Martino E.
      Adverse effects of thyroid hormone preparations and antithyroid drugs.
      Nevertheless, MMI-associated myocarditis was not mentioned in its drug assessment and was rarely reported in previous cases. We present a case of a young male patient who developed fever, chest discomfort, and joint symptoms after taking MMI. This patient provided clinical and laboratory information and agreed to the case publication with signed informed consent.
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