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01-01-2013 | Original Article

PTU-induced ANCA-positive vasculitis: an innocent or a life-threatening adverse effect?

Authors: N. Şule Yaşar Bilge, Timuçin Kaşifoğlu, Cengiz Korkmaz

Published in: Rheumatology International | Issue 1/2013

Abstract

Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides are rare, but they can be triggered by chemicals, infections and drugs; among them, antithyroid drugs are common. Autoimmune disorders, such as vasculitis, are unusual, but serious complications of antithyroid therapy. Both propylthiouracil (PTU) and methimazole may induce ANCA-associated vasculitis. PTU-induced vasculitides may have different organ involvement patterns. Herein, we report four cases with ANCA-associated vasculitis with different clinical manifestations.

Jennette JC, Falk RC (1997) Small-vessels vasculitis. N Engl J Med 337:1512–1523PubMedCrossRef

Yazisiz V, Öngüt G, Terzioğlu E, Karayalçin Ü (2010) Clinical importance of antineutrophil cytoplasmic antibody positivity during propylthiouracil treatment. Int J Clin Pract 64(1):19–24PubMedCrossRef

Cin OM, Gursoy A, Morris Y, Aydıntuğ OT, Kamel N, Gullu S (2009) Prevalence and clinical significance of antineutrophil cytoplasmic antibody in Graves’ patients treated with propylthiouracil. Int J Clin Pract 63(2):299–302PubMedCrossRef

Reumaux D, Duthilleul P, Roos D (2004) Pathogenesis of diseases associated with antineutrophil cytoplasmic antibodies. Hum Immunol 65:1–12PubMedCrossRef

Savage COS, Harper L, Holland M (2002) New findings in pathogenesis of antineutrophil cytoplasm antibody-associated vasculitis. Curr Opinion in Rheum 14:15–22CrossRef

Gao Y, Zhao MH (2009) Review article: drug-induced anti-neutrophil cytoplasmic antibody-associated vasculitis. Nephrology 14:33–41PubMedCrossRef

Bonaci-Nikolic B, Nikolic MM, Andrejevic S, Zoric S, Bukilica M (2005) Antineutrophil cytoplasmic antibody (ANCA)-associated autoimmune diseases induced by antithyroid drugs: comparison with idiopathic ANCA vasculitis. Arhtritis Res Ther 7:1072–1081CrossRef

Quax RAM, Swaak AJG, Baggen MGA (2009) Churg-Strauss Syndrome following PTU treatment. Int J Rheumatol 2009:504105. Epub 2009 Mar 8

Sato H, Hattori M, Fujieda M, Sugihara S, Inomata H, Hoshi M, Mıyamoto S (2000) High prevalence of antineutrophil cytoplasmic antibody positivity in childhood onset Graves’ disease treated with propylthiouracil. J Clin Endoctinol Metab 85:4270–4273CrossRef

10.

Mathieu E, Fain O, Sitbon M, Thomas M (1999) Systemic adverse effect of antithyroid drugs. Clin Rheumatol 18:66–68PubMedCrossRef

11.

Ozkok A, Salman S, Agan M et al (2009) Propylthiouracil induced anti-neutrophil cytoplasmic antibody-associated vasculitis with bone marrow plasmocytosis and granulocytopenia. Chin Med J 122(9):1112–1114PubMed

12.

Pietszkowski NC, Carvalho GA, Souza HN, Werka CR Jr, Borazo LA, Graf H, Carvalho M (2007) Antineutrophil cytoplasmic antibody (ANCA)-associated autoimmune disease induced by propylthiouracil. Arq Bras Endocrinol Metabol 51(1):136–141PubMedCrossRef

13.

Guma M, Salinas I, Reverter JL et al (2003) Frequency of antineutrophil cytoplasmic antibody in Graves’ disease patients treated with methimazole. J Clin Endocrinol Metab 88:2141–2146PubMedCrossRef

14.

Yu F, Chen M, Gao Y, Wang S, Zou W, Zhao M, Wang H (2007) Clinical and pathological features of renal involvement in propylthiouracil—associated ANCA—positive vasculitis. Am J Kid Disvol 49(5):607–614CrossRef

Title: PTU-induced ANCA-positive vasculitis: an innocent or a life-threatening adverse effect?
Authors: N. Şule Yaşar Bilge
Timuçin Kaşifoğlu
Cengiz Korkmaz
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Rheumatology International / Issue 1/2013
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-011-2280-5

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