title: Higher dose of methimazole causes frequent adverse effects in the management of Graves' disease in children and adolescents.
abstract: OBJECTIVE
  Methimazole (MMI) is used as a first-line antithyroid drug in children and adolescents with Graves' disease (GD). The aim of this study was to evaluate the correlation between the initial dose of MMI and the clinical course of GD after treatment.
  
  
  METHODS
  Retrospective and collaborative study.
  
  
  METHODS
  Nine facilities in Chiba prefecture, Japan.
  
  
  METHODS
  Sixty-four children and adolescents with GD were analyzed. The subjects were divided into three groups by the initial daily dose of MMI: group A, 0.4±0.1 mg/kg (mean±SD, n=11); group B, 0.7±0.2 (n=37); group C, 0.9±0.2 (n=16).
  
  
  METHODS
  The duration of time required for normalization of serum free T4 on initial treatment and the incidence of adverse effects for 1 year after the start of MMI were compared. Outcomes were compared among patients who were followed more than 3 years (group A, n=7; group B, n=24; group C, n=12).
  
  
  RESULTS
  Mean duration of times for normalization of T4 was 1.9±1.5 months in group A, 1.6±0.9 in group B and 1.9±1.5 in group C (NS). No major adverse reactions were observed. Minor adverse effects occurred in 9.1% of cases in group A, 13.5% in group B and 62.0% in group C (p<0.01). Remission rates did not differ among the three groups.
  
  
  CONCLUSIONS
  Higher doses of MMI are harmful for initial use in children and adolescents with GD.
authors: Nakayama Medical Square, Chiba, Japan. hschiba@aol.com
authors: Hirokazu
authors: H
authors: Sato
authors: Nozomu
authors: N
authors: Sasaki
authors: Kanshi
authors: K
authors: Minamitani
authors: Masanori
authors: M
authors: Minagawa
authors: Itsuro
authors: I
authors: Kazukawa
authors: Shigetaka
authors: S
authors: Sugihara
authors: Kunio
authors: K
authors: Wataki
authors: Susumu
authors: S
authors: Konda
authors: Hiroaki
authors: H
authors: Inomata
authors: Kazunori
authors: K
authors: Sanayama
authors: Yoichi
authors: Y
authors: Kohno
mesh_terms: D000293:Adolescent; D013956:Antithyroid Agents / Q000009:adverse effects*; D002648:Child; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008713:Methimazole / Q000009:adverse effects*; D012189:Retrospective Studies; D013974:Thyroxine / Q000097:blood
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole; D013974:Thyroxine