Propylthiouracil-induced diffuse proliferative lupus nephritis: review of immunological complications.
Propylthiouracil (PTU), used to treat Graves' disease, occasionally induces a lupus-like syndrome. A 39-year-old woman developed clinical manifestations of systemic lupus erythematosus with rash, serositis, myocarditis, and acute renal insufficiency, associated with serologies for lupus, after 3 wk of exposure to the drug. Renal biopsy revealed diffuse proliferative lupus nephritis. This article reviews the side effects of PTU and the literature on PTU-induced nephrotoxicity. Possible mechanisms and management of drug-induced lupus nephritis are also reviewed. To facilitate early and specific intervention, clinicians should be aware of the propensity of PTU to cause lupus-like syndromes with renal involvement.
Prasad
G V
GV
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
Bastacky
S
S
Johnson
J P
JP
D000328:Adult; D000936:Antigen-Antibody Complex / Q000378:metabolism; D013956:Antithyroid Agents / Q000009:adverse effects*; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D008181:Lupus Nephritis / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D011441:Propylthiouracil / Q000009:adverse effects*
D000936:Antigen-Antibody Complex; D013956:Antithyroid Agents; D011441:Propylthiouracil