title: [A case of myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA)-positive crescentic glomerulonephritis induced by propylthiouracil (PTU)].
abstract: We have experienced a case of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-related glomerulonephritis induced by propylthiouracil (PTU). A 45-year-old female had been treated with PTU for 4 years after the diagnosis of hyperthyroidism. She was referred to out hospital because of abrupt macroscopic hematuria and moderate proteinuria after several days of upper respiratory tract infection. On admission, her laboratory findings showed deterioration of renal function. Renal biopsy revealed crescentic glomerulonephritis without deposition of immune complexes. Her serology was found to be MPO-ANCA-positive and cytoplasmic-ANCA-negative. Based of these findings, we diagnosed idiopathic crescentic glomerulonephritis. Following the initiation of steroid pulse therapy, her urinary protein excretion and renal function gradually improved in parallel with a decrease in the MPO-ANCA titer. Although steroid therapy effectively responded to their renal function without the withdrawal of PTU, it seems that PTU may be closely associated with the development of (MPO-ANCA)-related glomerulonephritis in this case. Therefore, hyperthyroidism patients treated with PTU should be paced under vigilant observation by monitoring their urinalysis and serum creatinine level.
authors.affiliation: Second Department of Internal Medicine University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kato
authors.forename: A
authors.initials: A
authors.lastname: Osajima
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: R
authors.initials: R
authors.lastname: Serino
authors.forename: N
authors.initials: N
authors.lastname: Kabashima
authors.forename: M
authors.initials: M
authors.lastname: Tamura
authors.forename: K
authors.initials: K
authors.lastname: Segawa
authors.forename: H
authors.initials: H
authors.lastname: Anai
authors.forename: M
authors.initials: M
authors.lastname: Takasugi
authors.forename: Y
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D013956:Antithyroid Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis; D005260:Female; D005921:Glomerulonephritis / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D008875:Middle Aged; D009195:Peroxidase / Q000032:analysis*; D011441:Propylthiouracil / Q000009:adverse effects*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D015415:Biomarkers; D011441:Propylthiouracil; D009195:Peroxidase