title: Diffuse alveolar hemorrhage and pulmonary capillaritis due to propylthiouracil.
abstract: Propylthiouracil (PTU) has recently been observed to be associated with antineutrophil cytoplasmic antibody (ANCA)-positive small vessel vasculitis, resulting in crescentic glomerulonephritis and, infrequently, diffuse alveolar hemorrhage (DAH). We describe a case of a 23-year-old pregnant woman who developed a perinuclear ANCA and antimyeloperoxidase-positive small vessel vasculitis manifesting as DAH and crescentic glomerulonephritis after she began taking PTU. An open lung biopsy was consistent with pulmonary capillaritis. She responded to corticosteroid therapy and discontinuation of PTU. DAH can be caused by pulmonary capillaritis, bland hemorrhage, or diffuse alveolar damage. To our knowledge, this represents the first documentation of an underlying pulmonary capillaritis in a case of PTU-induced DAH.
authors.affiliation: Saint Elizabeth Health Center, Youngstown, OH 44501-1970, USA. samjot@rocketmail.com
authors.forename: S S
authors.initials: SS
authors.lastname: Dhillon
authors.forename: D
authors.initials: D
authors.lastname: Singh
authors.forename: N
authors.initials: N
authors.lastname: Doe
authors.forename: A M
authors.initials: AM
authors.lastname: Qadri
authors.forename: S
authors.initials: S
authors.lastname: Ricciardi
authors.forename: M I
authors.initials: MI
authors.lastname: Schwarz
mesh_terms: D000328:Adult; D000963:Antimetabolites / Q000009:adverse effects*; D001706:Biopsy; D002196:Capillaries / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D008171:Lung Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D011261:Pregnancy Trimester, First; D011441:Propylthiouracil / Q000009:adverse effects*; D011650:Pulmonary Alveoli / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D013902:Radiography, Thoracic; D014657:Vasculitis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000963:Antimetabolites; D005938:Glucocorticoids; D011441:Propylthiouracil