Ending Propylthiouracil-Induced Liver Failure in Children

To the Editor: Graves' disease is treated with antithyroid drugs, radioactive iodine, or surgery.1,2 Propylthiouracil and methimazole are widely used in children as first-line therapy.1,2 Over the past 60 years of propylthiouracil and methimazole use, reports of propylthiouracil-related liver failure and death have accumulated.3–5 In contrast, this problem has not been reported with methimazole use in children.3,5 Several observations can be made on the basis of the medical literature, adverse event reports from the Food and Drug Administration (FDA), and extensive data presented at a workshop at the Eunice Kennedy Shriver National Institute of Child Health . . .