CONTEXT Graves' disease affects 3% of women and 0.5% of men in the general population. The first line treatment of Graves' hyperthyroidism is based on the administration of antithyroid drugs (ATD), propylthiouracil (PTU), methimazole (MMI) and carbimazole. A recent warning from the Italian Drug Agency (Agenzia Italiana del Farmaco AIFA) reported the risk of MMI-induced acute pancreatitis. In addition, AIFA highlighted the possible association of MMI treatment during the first trimester of pregnancy with congenital malformations, thus recommending the use of effective contraceptive methods in women of childbearing age treated with MMI. METHODS AND RESULTS Revision of literature reported less than ten cases of the alleged MMI pancreatitis, allowing the inclusion of MMI in class III drug regarding the relative risk for drug-induced pancreatitis. Data available on the effect of hyperthyroidism per se on the risk of fetal malformations, although scanty, are sufficient to recommend treatment with ATD of the hyperthyroid pregnant woman. Case reports and population studies either suggesting or not suggesting MMI-induced fetal malformations do not allow unquestionable conclusions on this matter. CONCLUSIONS This consensus by experts from Italian Endocrine and Gynecologic Scientific Societies has edited recommendations derived form the available data and published guidelines of International Scientific Societies.

中文翻译：

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用亚硫酰胺治疗Graves甲状腺功能亢进症：关于怀孕适应症和安全性的立场文件。

背景格雷夫斯氏病影响了普通人群中的3％的女性和0.5％的男性。Graves甲状腺功能亢进症的一线治疗是基于抗甲状腺药物（ATD），丙硫氧嘧啶（PTU），甲巯咪唑（MMI）和卡巴咪唑的给药。意大利药品管理局（Agenzia Italiana del Farmaco AIFA）最近发出警告，报告了MMI诱发急性胰腺炎的风险。此外，AIFA强调了妊娠早期三个月MMI治疗与先天性畸形的可能联系，因此建议在接受MMI治疗的育龄妇女中使用有效的避孕方法。方法和结果文献修订报告称少于十例的所谓的MMI胰腺炎，允许将MMI纳入有关药物引起的胰腺炎相对风险的III类药物中。甲亢本身对胎儿畸形风险的影响的可用数据尽管很少，但足以推荐对甲亢孕妇进行ATD治疗。病例报告和人群研究均提示或不提示MMI引起的胎儿畸形，均不能在此问题上得出毫无疑问的结论。结论意大利内分泌和妇科科学学会的专家达成的共识已编辑了从现有数据得出的建议，并出版了国际科学学会的指南。足以推荐甲亢孕妇的ATD治疗。病例报告和人群研究均提示或不提示MMI引起的胎儿畸形，均不能在此问题上得出毫无疑问的结论。结论意大利内分泌和妇科科学学会的专家达成的共识已编辑了从现有数据得出的建议，并出版了国际科学学会的指南。足以推荐甲亢孕妇的ATD治疗。病例报告和人群研究均提示或不提示MMI引起的胎儿畸形，均不能在此问题上得出毫无疑问的结论。结论意大利内分泌和妇科科学学会的专家达成的共识已编辑了从现有数据得出的建议，并出版了国际科学学会的指南。