Carbimazole-Induced Cholestatic Jaundice with Heterozygous Mutant of H63D for Hemochromatosis

Abstract

Carbimazole belongs to thionamide group of drugs and inhibits thyroid hormone synthesis by preventing organification of iodine to tyrosine residue in thyroglobulin as well as coupling of iodotyrosines. Although most of the side effects are minor such as rash, serious side effects such as hepatotoxicity and agranulocytosis have also been reported. The occurrence of carbimazole-induced hepatotoxicity has overall risk of <0.5%. Before confirming the diagnosis of cholestatic jaundice secondary to carbimazole, other causes has to be excluded as well. We report an interesting as well as rare case of cholestatic jaundice in a 50-year-old female who is a known case of hyperthyroidism who presented with icterus, generalized itching for 15 days duration and later on found to have hyperferritinemia, increased transferrin saturation, heterozygous mutant for H63D gene for hemochromatosis.