Centre for Endocrine and Diabetes Sciences, Department of Medicine, Cardiff University School of Medicine, Cardiff, UK
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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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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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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
London School of Hygiene and Tropical Medicine, London
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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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]. 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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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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, 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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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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Departments of Scuola Superiore Sant'Anna, Pisa, Italy
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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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.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