COMPLICATIONS ASSOCIATED WITH THIOUREA THERAPY

Abstract

We reviewed the clinical courses of 105 children with hyperthyroidism: 69 received propylthiouracil (PTU), 29 received Tapazole (TAP) and 7 were begun on one drug and later switched to the other (for purposes of analysis, these 7 were included in both groups). Choice of drug depended on the individual physician's preference. The mean ± 1 SD duration of therapy for PTU was 20± 16 months, and for TAP 16± 12 mos. Prior to therapy, there were no significant differences in the two treatment groups with respect to age, gender, family history of thyroid disease, mean T4 concentration,or mean goiter size. There were no significant differences in the clinical remission rates in the two groups (45.7% for PTU and 29.4% for TAP, p=0.11). However, hepatitis or collagen-like diseases occurred more frequently in children treated with PTU (14/76, 18%) than in children treated with TAP (0/36, p<0.006 by chi square). In contrast, there were no significant differences in the frequency of leukopenia (4.3 v. 2.9%) or rash (2.9 v. 8.9%, respectively, p=NS). The occurrence of hepatitis or collagen-like illness did not appear to be related to dosage or duration of therapy. In conclusion, the efficacy of the two drugs appears to be similar but serious complications occur more frequently with PTU. Therefore, TAP would appear to be the drug of choice in initial therapy of hyperthyroidism in children.

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