Propylthiouracil (PTU) Hepatoxicity in Children and Recommendations for Discontinuation of Use
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PTU can cause fulminant hepatic necrosis that may be fatal; liver transplantation has been necessary in some patients taking PTU.
“In contrast, PTU can cause fulminant hepatic necrosis that may be fatal; liver transplantation has been necessary in some patients taking PTU (132).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [326]
The FDA issued a black box warning regarding the use of PTU, noting that 32 cases of serious liver injury have been associated with PTU use.
“For this reason, the FDA issued a black box warning regarding the use of PTU (328), noting that 32 (22 adult and 10 pediatric) cases of serious liver injury have been associated with PTU use (326,328).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [326]
PTU is associated with an unacceptable risk of hepatotoxicity in children, with a risk of liver failure of 1 in 2000-4000 children taking the medication.
“PTU is associated with an unacceptable risk of hepatotoxicity in children, with a risk of liver failure of 1 in 2000-4000 children taking the medication (326,327).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [326]
MMI may also be associated with hepatotoxicity in children, but this tends to be milder and is typically cholestatic rather than hepatocellular.
“MMI may also be associated with hepatotoxicity in children, but this tends to be milder and is typically cholestatic rather than hepatocellular (326).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [326]
In children, the risks of MMI-related cholestasis and hepatocellular injury appear to be much less than those observed in adults.
“In children, the risks of MMI-related cholestasis and hepato-cellular injury appear to be much less than those observed in adults (326).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [326]
At least one case of cholestatic jaundice has been reported in a child with MMI.
“At least one case of cholestatic jaundice has been reported in a child (326).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [326]
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References 54 · Cited by 90
- Authors
- Rivkees, S., & Mattison, D.
- Affiliations
- Yale University (US)
- Corresponding author
- Rivkees, ScottA
- Venue
- International Journal of Pediatric Endocrinology
- Published
- 2009
- Volume
- 2009
- Issue
- 1
- Pages
- 132041
- ISSN
- 1687-9848 (ISSN-L)
- 1687-9856
- OpenAlex
- W4248665466
- Cited by
- 90
- References
- 54
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 9 · 2020: 2 · 2019: 5 · 2018: 8 · 2017: 6 · 2016: 9 · 2015: 4 · 2014: 10 · 2013: 6 · 2012: 7
- FWCI
- 5.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- International Journal of Pediatric Endocrinology (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- propylthiouracil, hepatotoxicity, drug-induced liver injury, antithyroid drugs, pediatric patients, drug discontinuation, adverse drug reactions
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