Abstract
Thionamide drugs are widely used in the management of hyperthyroidism and are infrequently associated with adverse reactions. The development of the nephrotic syndrome during methimazole (Tapazole) therapy in a young man with Graves'' disease is reported. His proteinuria remitted promptly with discontinuance of the drug, and renal histologic features bore a striking resemblance to the toxic nephrosis induced in animals by the aminonucleoside of puromycin. In view of the histologic similarities, it is proposed that methimazole acted as a direct glomerular toxin, inducing the nephrotic syndrome in this patient.

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