Drug May Be Dangerous for Kids With Graves' Disease
FRIDAY, April 17 -- A recommendation to restrict the use of the antithyroid drug (PTU) in children has been endorsed by the Endocrine Society.
In a letter to the editor in the April 9 New England Journal of Medicine, two experts wrote that PTU can cause severe liver disease in children and should no longer be used as a first-line treatment for children with Graves' disease, a disorder in which the thyroid gland produces more thyroid hormone than the body needs.
Liver damage has not been seen in children treated with the other thionamide derivative, methimazole, noted Dr. Scott A. Rivkees, of Yale University Medical School, and Dr. Donald R. Mattison, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The Endocrine Society said this week that it supports the recommendation.
"Despite the relative rarity of Graves' disease in the young, children and adolescents account for as many as 13 of 42 cases of serious PTU-related liver failure reported to date in the medical literature and a similar disproportionate number (4 of 13) of those requiring liver transplant for this indication between 1990-2002," the society said in a news release.
An estimated 40,000 children are treated for Graves' disease each year in the United States. If 40 percent of those children are treated with PTU, then as many as one to two of those children could develop severe liver disease that could lead to a liver transplant or death.
"Even one excess death is too many if it can be prevented," the society said. It suggested that until more study was done, methimazole ought to be considered the preferred treatment for children.
The U.S. National Endocrine and Metabolic Diseases Information Service has more on Graves' disease.
Posted: April 2009