Pyoderma gangrenosum with secondary pyarthrosis following propylthiouracil.
The association of pyoderma gangrenosum and arthritic symptoms is well documented. We present a rarely reported variant of this in a 44-year-old woman with pyoderma gangrenosum and bilateral large purulent effusions of her knees. She had no evidence of underlying rheumatoid arthritis or a specific seronegative spondyloarthropathy. Of note she had a history of Graves' disease for which she had been treated with propylthiouracil for 3 years and on investigation at this presentation had a markedly elevated perinuclear antineutrophil cytoplasm antibody (P-ANCA) level with specificities for IgM myeloperoxidase, IgG elastase and IgG lactoferrin. We believe this patient had pyoderma gangrenosum with secondary sterile pyarthrosis and a P-ANCA precipitated by propylthiouracil.
Darben
T
T
Department of Dermatology, Royal Brisbane Hospital, Herston, Queensland, Australia.
Savige
J
J
Prentice
R
R
Paspaliaris
B
B
Chick
J
J
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D000963:Antimetabolites / Q000009:adverse effects*; D016918:Arthritis, Reactive / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D005260:Female; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D008911:Minocycline / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011441:Propylthiouracil / Q000009:adverse effects*; D017511:Pyoderma Gangrenosum / Q000150:complications* / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D012867:Skin / Q000473:pathology
D019268:Antibodies, Antineutrophil Cytoplasmic; D000963:Antimetabolites; D011441:Propylthiouracil; D011239:Prednisolone; D008911:Minocycline