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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Cohen, Pinhas / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Feihong / Mericq, Veronica / Roth, Christian / Toppari, Jorma

Editorial Board Member: Battelino, Tadej / Buyukgebiz, Atilla / Cassorla, Fernando / Chrousos, George P. / Cutfield, Wayne / Fideleff, Hugo L. / Hershkovitz, Eli / Hiort, Olaf / LaFranchi, Stephen H. / Lanes M. D., Roberto / Mohn, Angelika / Root, Allen W. / Rosenfeld, Ron G. / Werther, George / Zadik, Zvi

12 Issues per year


IMPACT FACTOR 2016: 1.233

CiteScore 2016: 1.09

SCImago Journal Rank (SJR) 2016: 0.527
Source Normalized Impact per Paper (SNIP) 2016: 0.602

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2191-0251
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Volume 25, Issue 7-8 (Aug 2012)

Issues

Pathogenesis of propylthiouracil-related hepatotoxicity in children: present concepts

Spiros Karras
  • Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece
  • Other articles by this author:
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/ Eleni Memi
  • Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece
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/ Evangelia Kintiraki
  • Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece
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/ Gerasimos E. Krassas
  • Corresponding author
  • Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece
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Published Online: 2012-06-28 | DOI: https://doi.org/10.1515/jpem-2012-0059

Abstract

Propylthiouracil (PTU), carbimazole (CMZ) and methimazole (MMI) are the most common drugs used today in cases of adolescent thyrotoxicosis. Skepticism has been growing regarding the use of PTU in childhood and its association with severe liver failure. The aim of this review is to present all the recent data regarding pathogenesis of PTU hepatotoxicity in children and adolescents. Specifically, reactive drug metabolites and increased oxidative stress can directly activate inflammatory and immunological pathways. Drugs are not only immunogenic because of their chemical reactivity but also because they may bind through electrostatic forces to available T-cell receptors. Redox modulation is also a key regulatory strategy in the adaptive immune system. Subtle changes in the extracellular redox status may cause profound functional changes in redox-sensitive proteins. Genetic factors that affect drug biotransformation could also be implicated in this mechanistic model of PTU-related hepatotoxicity. Further studies are needed to fully understand the pathophysiology of PTU-induced liver damage.

Keywords: children; hepatotoxicity; pathogenesis; PTU

About the article

Corresponding author: Prof. Gerasimos E. Krassas, MD, PhD, FRCP(Lond), Tsimiski 92, 54622 Thessaloniki, GreecePhone: +30 23 1030 9351


Received: 2012-02-28

Accepted: 2012-05-03

Published Online: 2012-06-28

Published in Print: 2012-08-01


Citation Information: Journal of Pediatric Endocrinology and Metabolism, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2012-0059.

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©2012 by Walter de Gruyter Berlin Boston. Copyright Clearance Center

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