the Safety of long term use of proplythouracil

[Guest guest]

For thoses concerned about the long term use of anti-thyroid medications:

Here is the abstract of an article that describes the rare vasculitis that can

occur with long terk use of ptu.It describes what happened to me. I am not

opposed to long term use of ATDs but I think everyone should be aware of all

possible harmful side effects, even those that are rare.

If you wish to read the entire article

http://www.eje.org/eje/142/0587/1420587.pdf

Prevalence of positive anti-neutrophil cytoplasmic antibody (ANCA) in patients

receiving anti-thyroid medication.

Gunton JE, Stiel J, Clifton-Bligh P, Wilmshurst E, McElduff A.

Department of Endocrinology, Royal North Shore Hospital, St Leonards, Sydney,

Australia. jennyg@...

OBJECTIVE: Vasculitis is a rare complication of anti-thyroid medications. There

are 32 cases of anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis

in association with anti-thyroid medication reported in the English literature.

The objectives of this study were to assess the frequency of positive ANCA in

patients on long-term anti-thyroid medication, and to follow patients

prospectively from commencement of medication to determine whether they became

ANCA-positive after therapy. DESIGN: Prospectively collected cross-sectional

study of two groups of patients: (i) who had received long-term (>18 months)

anti-thyroid medication, and (ii) newly diagnosed thyrotoxicosis before

commencement of anti-thyroid medication attending clinic between 28 April 1998

and 30 September 1998. Data were collected for age, sex, ethnicity, underlying

thyroid disease, medication and duration, and symptomatology. RESULTS: Eight of

30 patients on long-term anti-thyroid medication (26.7%) were ANCA-positive. All

ANCA-positive patients were female, seven were taking propylthiouracil (PTU) at

the time of testing. ANCA-positive patients had taken PTU for a mean +/- s.d. of

7.9+/-10.2 years, compared with 0.8+/-2.2 years in ANCA-negative patients

(Mann-Whitney, P<0.0001). The ten patients with newly diagnosed thyrotoxicosis

were ANCA-negative before commencement of carbimazole. One (10%) became

ANCA-positive within 8 months of therapy. CONCLUSIONS: In our population,

ANCA-positivity in association with long-term anti-thyroid medication is common

(26.7%). One patient who was ANCA-negative prior to anti-thyroid therapy has

become ANCA-positive. ANCA should be tested in patients receiving long-term

anti-thyroid medications, and in patients with adverse reactions. As PTU is more

commonly associated with vasculitis and positive ANCA, carbimazole may be the

preferred medication for long-term use. Patients with positive ANCA should be

followed, and considered for definitive anti-thyroid therapy, to allow cessation

of medication. ANCA-positivity may resolve after cessation of anti-thyroid

medication.

Aileen