[Side effects of antithyroid drugs].
In order to investigate the incidence of side effects of antithyroid drugs and to study if there were any factors related to the onset of the side effects, clinical and laboratory findings were examined in 71 untreated Graves' patients. The overall incidence was 28.2% among 71 cases who were initially administered methimazole or propylthiouracil. The incidences were 23.2% (13 of 56 cases) for methimazole and 46.7% (7 of 15 cases) for propylthiouracil, respectively, which were significantly higher than those previously reported. Seventeen of 20 cases with side effects under the drug of first choice were administered the another antithyroid drug. Four of 17 (23.5%) cases successively had side effects. The side effects were observed within 1.5 months of administration of less than 150 tablets in total in most of the cases. The serum concentration of Ig-E and peripheral eosinophils(/mm3) at the onset of the side effects were significantly higher than those before treatment. These results suggest that allergic mechanism rather than accumulating may concern the onset of side effects. Since in cases without the side effects the peripheral eosinophils at 3 to 4 weeks after administration were significantly higher than those before treatment and 19 of 51 (38.0%) cases without side effects had a high concentration of Ig-E of more than 500 u/ml, it is suggested that allergic mechanism may be triggered in most of Graves' patients who were administered methimazole or propylthiouracil. Thus, immunological disturbances in Graves' disease seems to be the cause of the side effects of antithyroid drugs, although there was no correlation between antithyroid autoantibodies and development of the side effects.
D000293:Adolescent; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury; D004804:Eosinophils; D005260:Female; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007958:Leukocyte Count; D008297:Male; D008713:Methimazole / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D011441:Propylthiouracil / Q000008:administration & dosage / Q000009:adverse effects*
D007073:Immunoglobulin E; D008713:Methimazole; D011441:Propylthiouracil