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One of these investigations resulted that methimazole administration caused lower severe hepatotoxic events and vasculitis in children than the other drug, PTU.29 Interestingly, it has been reported that there are no reports of liver failure or liver transplantation in association with methimazole use in children in united states.11 Furthermore, there are fewer and less serious adverse events reported in FDA database for methimazole than for PTU.11 A substantial amount of data obtained from evidence based and prospective studies are indicated that methimazole is a safer pharmaceutical in management of hyperthyroidism in children.11,79 Some severe and even fatal PTU-induced liver injury cases are reported in children treated with this medication.80,81 Hence, some investigators suggested that PTU should no longer be used as a first line treatment for Graves' disease in children.11 Some studies showed that a shift in propylthiouracil prescription has occurred during years (Fig