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Peter Taylor Departments of Diabetes and Endocrinology, Royal United Hospital, Bath
Centre for Endocrine and Diabetes Sciences, Department of Medicine, Cardiff University School of Medicine, Cardiff, UK

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Sandip Bhatt Departments of Gastroenterology, Royal United Hospital, Bath

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Ravi Gouni Departments of Diabetes and Endocrinology, Royal United Hospital, Bath

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Jonathan Quinlan Departments of Gastroenterology, Royal United Hospital, Bath

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Tony Robinson Departments of Diabetes and Endocrinology, Royal United Hospital, Bath

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fetal loss [ 4 , 6 ]. • Anti-thyroid drugs are the mainstay of treatment throughout pregnancy [ 7 , 8 ]. • Propylthiouracil (PTU) is generally used first line in pregnancy following an increased incidence of scalp defects such as aplasia cutis [ 9

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Spiros Karras Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece

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Gerasimos E. Krassas Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece

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endocrinologists for Graves’ hyperthyroidism (GH). The same applies for cases of postpartum thyrotoxicosis. Pharmacokinetics of ATD ATD which are used today include propylthiouracil (PTU), carbimazole (CMZ) and methimazole (MMI) [ 6 ]. CMZ is a prodrug

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Eddy Rijntjes Institut für Experimentelle Endokrinologie, Charité-Universtätsmedizin Berlin, Berlin, Germany

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Philip Moritz Scholz Institut für Experimentelle Endokrinologie, Charité-Universtätsmedizin Berlin, Berlin, Germany

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Govindasamy Mugesh Department of Inorganic and Physical Chemistry, Indian Institute of Science, Bangalore, India

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Josef Köhrle Institut für Experimentelle Endokrinologie, Charité-Universtätsmedizin Berlin, Berlin, Germany

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in propylthiouracil and methimazole-prescribing practices: antithyroid drug use in the United States from 1991 to 2008. J Clin Endocrinol Metab 2010;95:2227-2233. 10.1210/jc.2009-2752 20335447 2 Rivkees SA, Mattison DR: Propylthiouracil

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Peter N. Taylor Thyroid Research Group, Institute of Experimental and Molecular Medicine, School of Medicine, Cardiff University, Cardiff
London School of Hygiene and Tropical Medicine, London

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Bijay Vaidya Department of Endocrinology, Royal Devon and Exeter Hospital and Peninsula Medical School, Exeter, UK

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pregnant women with hyperthyroidism [ 6 ]. However, carbimazole (CBZ), its active metabolite, methimazole (MMI) and propylthiouracil (PTU) are all thought to be equally effective in controlling hyperthyroidism [ 7 ]. Therefore, the choice of ATD is not

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P. Reed Larsen Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard Institutes of Medicine, Boston, Mass., USA

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Ann Marie Zavacki Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard Institutes of Medicine, Boston, Mass., USA

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]. Another unique feature of D1 is that its activity is blocked by propylthiouracil (PTU) [ 30 ]. This is thought to occur through the competition of the thiol group of PTU with the endogenous thiols which are required for the reduction of the Se-I complex

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Hiroyuki Iwaki Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Kenji Ohba Medical Education Center, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Eisaku Okada Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Takeshi Murakoshi Obstetrics and Gynecology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Yumiko Kashiwabara Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Chiga Hayashi Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Akio Matsushita Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Shigekazu Sasaki Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Takafumi Suda Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Yutaka Oki Department of Metabolism and Endocrinology, Hamamatsu-Kita Hospital, Hamamatsu, Japan

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Rieko Gemma Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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of ATDs on fetal thyroid hormone status; specifically, Gardner et al. [ 3 ] identified a significant inverse correlation between the cord serum FT4 index and the area under the curve for maternal serum propylthiouracil concentrations. ATD dosage was

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Kris Poppe Endocrine Unit, Department of Internal Medicine, University Hospital UZ Brussel (VUB), Brussels, Belgium

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Alicja Hubalewska-Dydejczyk Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland

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Peter Laurberg Department of Endocrinology and Medicine, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

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Roberto Negro Division of Endocrinology, V. Fazzi Hospital, Lecce

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Francesco Vermiglio Cattedra di Endocrinologia, Policlinico Universitario, Messina, Italy

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Bijay Vaidya Department of Endocrinology, Royal Devon & Exeter Hospital, Exeter, UK

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, 6 ]. However, there have been several reports of severe congenital malformations (the ‘methimazole embryopathy’) associated with methimazole (MMI) or carbimazole (CMZ) use in early pregnancy, and recently it has been highlighted that propylthiouracil

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John H. Lazarus Centre for Endocrine and Diabetes Sciences, Cardiff University, Cardiff, UK

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the medical or surgical therapy groups (p < 0.01). From Laurberg et al. [16]. Treatment with antithyroid drugs (carbimazole/methimazole or propylthiouracil (PTU)) is acceptable either before pregnancy or during pregnancy. However, the risks

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Riccardo Donzelli Departments of Pathology, University of Pisa

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Daria Colligiani Departments of Clinical and Experimental Medicine, University of Pisa

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Claudia Kusmic Departments of CNR Institute of Clinical Physiology, Pisa, Italy

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Martina Sabatini Departments of Pathology, University of Pisa

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Leonardo Lorenzini Departments of Pathology, University of Pisa

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Alice Accorroni Departments of Pathology, University of Pisa
Departments of Scuola Superiore Sant'Anna, Pisa, Italy

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Monica Nannipieri Departments of Clinical and Experimental Medicine, University of Pisa

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Alessandro Saba Departments of Pathology, University of Pisa

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Giorgio Iervasi Departments of CNR Institute of Clinical Physiology, Pisa, Italy

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Riccardo Zucchi Departments of Pathology, University of Pisa

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investigation, HPLC-MS/MS was used to determine tissue-specific T 3 and T 4 concentration in rat organs under control conditions, in propylthiouracil-induced hypothyroidism, and after administration of exogenous T 3 or T 4 . Our aim was to characterize tissue

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria ‘S. Maria della Misericordia', Udine

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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.7% would suggest RAI (fig. 2 d). If the chosen treatment is ATD, 61% would suggest using propylthiouracil (PTU) rather than MMI before the pregnancy, and PTU would be continued by 55.1% of physicians during all the three trimesters; if the patient became

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