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[Adverse reactions of methimazole in children with hyperthyroidism]
1Department of Pediatric Endocrinology, Genetics and Metabolism, Shengjing Hospital Affiliated to China Medical University, Shenyang 110000, China.
Insights
Adverse reactions to methimazole are common in children with hyperthyroidism, often occurring within three months and resolving with treatment. Younger children and those with lower neutrophil counts face a higher risk of neutropenia.
Area of Science:
- Pediatric Endocrinology
- Pharmacovigilance
- Internal Medicine
Context:
- Hyperthyroidism in children requires effective treatment.
- Methimazole is a common antithyroid medication.
- Understanding adverse reactions is crucial for patient safety.
Purpose:
- To determine the incidence of methimazole adverse reactions in pediatric hyperthyroidism.
- To identify risk factors for these adverse events.
Summary:
- A retrospective analysis of 304 children with hyperthyroidism treated with methimazole revealed an adverse reaction incidence of 28.6%.
- Common reactions included neutropenia (12.8%), rash (11.8%), and elevated ALT (9.5%), typically occurring within 1-3 months.
- Younger age and lower baseline absolute neutrophil count were identified as risk factors for neutropenia.
Impact:
- Findings highlight the frequency of methimazole adverse reactions in children.
- Early identification of at-risk children can guide preventative strategies.
- This research supports informed clinical decision-making for pediatric hyperthyroidism management.
Objectives:
To investigate the incidence rate of adverse reactions of methimazole in children with hyperthyroidism.
Methods:
A retrospective analysis was performed on the medical data of 304 children with hyperthyroidism who were hospitalized in Shengjing Hospital of China Medical University from January 2015 to May 2021. The incidence rate of methimazole-related adverse reactions was analyzed. The risk factors for common adverse reactions were evaluated.
Results:
Among the 304 children, 87 (28.6%) experienced adverse reactions, among whom there were 20 boys (23%) and 67 girls (77%). Common adverse reactions included neutropenia (12.8%), rash (11.8%), elevated alanine aminotransferase (9.5%), and joint pain (3.0%), and some children experienced multiple adverse reactions simultaneously or intermittently. Neutropenia often occurred within 3 months after administration (25/39, 64%), elevated alanine aminotransferase often occurred within 1 month after administration (17/29, 59%), and rash often occurred within 3 months after administration (30/36, 83%). Most of the above adverse reactions returned to normal after symptomatic treatment. The multivariate logistic regression analysis showed that younger age and lower absolute neutrophil count before treatment were risk factors for neutropenia after methimazole treatment (P<0.05).
Conclusions:
The adverse reactions of methimazole are common in children with hyperthyroidism, and most adverse reactions occur within 3 months after administration and can be relieved after symptomatic treatment. Children with a younger age or a lower baseline absolute neutrophil count may have a higher risk of neutropenia.
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