Propylthiouracil-induced perinuclear-staining antineutrophil cytoplasmic autoantibody-positive vasculitis in conjunction with pericarditis.
OBJECTIVE
To describe a case of propylthiouracil-induced vasculitis manifesting with pericarditis.


METHODS
We present the first case report of a woman with hyperthyroidism treated with propylthiouracil in whom a syndrome of pericarditis, fever, and glomerulonephritis developed. Serologic testing and immunologic studies were done, and a pericardial biopsy was performed.


RESULTS
A 25-year-old woman with Graves' disease had a febrile illness and evidence of pericarditis, which was confirmed by biopsy. Serologic evaluation revealed the presence of perinuclear-staining antineutrophil cytoplasmic autoantibodies (pANCA) against myeloperoxidase (MPO). Propylthiouracil therapy was withdrawn, and she was treated with a 1-month course of prednisone, which alleviated her symptoms. A literature review revealed no prior reports of pericarditis in anti-MPO pANCA-positive vasculitis associated with propylthio- uracil therapy.


CONCLUSIONS
Pericarditis may be the initial manifestation of drug-induced vasculitis attributable to propylthio- uracil therapy.
New York Hospital Medical Center of Queens, Flushing, USA.
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Colakovski
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Lorber
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D005260:Female; D005334:Fever; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010493:Pericarditis / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D009195:Peroxidase / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use; D011441:Propylthiouracil / Q000009:adverse effects*; D013610:Tachycardia; D014657:Vasculitis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D011441:Propylthiouracil; D009195:Peroxidase; D011241:Prednisone