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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Severe propylthiouracil-induced hepatotoxicity in pregnancy managed successfully by liver transplantation: A case report | Sequeira et al. Journal of Medical Case Reports 2011 5 461 http www.jmedicalcasereports.eom content 5 1 461 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Severe propylthiouracil-induced hepatotoxicity in pregnancy managed successfully by liver transplantation A case report Evan Sequeira Sikolia Wanyonyi and Raj Dodia Abstract Introduction Propylthiouracil-induced severe hepatotoxicity is a relatively rare occurrence with very few cases reported in the literature. The management of this complication in pregnancy can be a challenge because of the effects of the various treatment options on the fetus. Case presentation We report a rare case of fulminant hepatic failure in a 36-year-old gravida 2 black woman of African descent that occurred at 17 weeks gestation following propylthiouracil treatment for Graves disease. Her liver failure was managed by liver transplantation and thyroidectomy. Her pregnancy was continued to term though with not so favorable early childhood sequelae. Conclusion This case illustrates a very rare complication of treatment with a presumed safe drug during pregnancy followed by adverse neonatal outcomes due to the extensive treatment. Introduction Propylthiouracil PTU -induced severe hepatotoxicity is a relatively rare occurrence despite observed transient increases in liver function test values at the initiation of treatment 1 2 . A one in 10 000 incidence of liver failure following PTU treatment has been reported in the United States of America 3 . Fulminant hepatic failure during pregnancy occurs more frequently in the third trimester of gestation and its etiology usually derives from obstetric-related conditions and or infectious diseases 4 5 . Management of this condition poses an ethical dilemma as the clinician has to choose between maternal well-being and fetal health. We report a rare case of fulminant hepatic failure in the second trimester following PTU treatment for severe thyrotoxicosis in pregnancy that was successfully