Methimazole-Induced Antithyroid Arthritis Syndrome in Graves' Disease Management: A Case Report

21 October 2025 : Case report China

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease, Adverse events of drug therapy

Kin-Weng Sun

^{E 1,2}, Aixin Wu

^{ABDF 1*}

DOI: 10.12659/AJCR.949509

Am J Case Rep 2025; 26:e949509

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Table 1 Naranjo ADR Probability Scale.

Question	Yes	No	Unknown	Score
Are there previous conclusive reports on this reaction?	+1	0	0	+1
Did the adverse event appear after the suspected drug was administered?	+2	−1	0	+2
Did the adverse reaction improve when the drug was discontinued, or a specific antagonist was administered?	+1	0	0	+1
Did the adverse reaction reappear when the drug was readministered?	+2	−1	0	+2
Are there alternative causes (other than the drug) that could on their own have caused the reaction?	−1	+2	0	+2
Did the reaction reappear when a placebo was given?	−1	+1	0	0
Was the drug detected in the blood (or other fluids) in concentrations known to be toxic?	+1	0	0	0
Was the reaction more severe when the dose was increased or less severe when the dose was decreased?	+1	0	0	0
Did the patient have a similar reaction to the same or similar drug in any previous exposure?	+1	0	0	0
Was the adverse event confirmed by any objective evidence?	+1	0	0	+1
Total score				9 (Highly probable)
ADR – adverse drug reaction. Score interpretation: above 9=highly probable, 5–8=probable, 1–4=possible, and 0=doubtful.

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