Abstract
The frequency and types of adverse events after initial antithyroid drug (ATD) therapy during pregnancy have never been reported, nor has whether the frequency of adverse events is the same as among nonpregnant subjects ever been investigated. We investigated retrospectively the frequency of adverse events after initial ATD administration to previously untreated Graves' disease (GD) patients during pregnancy. We reviewed the charts of cases of 91 untreated pregnant women who came to our hospital for the first time and were newly diagnosed with GD during the period between January 1, 1999, and December 31, 2011. Thiamazole (MMI) was used to treat 40 patients and 51 patients were treated with propylthiouracil (PTU). Adverse events occurred in 5 patients (5/40; 12.5%) treated with MMI, and they consisted of cutaneous reactions in 5 patients. Adverse events occurred in five patients (5/51; 9.8%) treated with PTU, and they consisted of hepatotoxicity in two patients and cutaneous reactions in three patients. No patients experienced agranulocytosis or ANCA-related vasculitis. Comparison with the expected rate of adverse events in nonpregnant individuals showed that the frequency of adverse events in pregnant individuals was low.
Highlights
Thyrotoxicosis occurs in approximately 0.2% of pregnancies, and the most common cause of thyrotoxicosis is Graves’ disease (GD) [1, 2]
Frequencies of adverse events in Japanese GD patients after initial antithyroid drug (ATD) treatment have recently been reported [3, 4], and according to the reports the percentage of patients with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels more than twice the upper limit of the reference range was 25.8–26.9% among patients treated with PTU as opposed to 6.6–9.0% among patients treated with MMI, and the percentage of patients with a cutaneous reaction was 18.3–22.1% among the patients treated with PTU and 6.6–31.9% among the patients treated with MMI
In this study we investigated the frequency of adverse events in untreated pregnant GD patients after initial ATD treatment during pregnancy
Summary
Thyrotoxicosis occurs in approximately 0.2% of pregnancies, and the most common cause of thyrotoxicosis is Graves’ disease (GD) [1, 2]. Frequencies of adverse events in Japanese GD patients after initial ATD treatment have recently been reported [3, 4], and according to the reports the percentage of patients with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels more than twice the upper limit of the reference range was 25.8–26.9% among patients treated with PTU as opposed to 6.6–9.0% among patients treated with MMI, and the percentage of patients with a cutaneous reaction (skin eruption or urticarial eruption) was 18.3–22.1% among the patients treated with PTU and 6.6–31.9% among the patients treated with MMI. In this study we investigated the frequency of adverse events in untreated pregnant GD patients after initial ATD treatment during pregnancy
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