Methimazole-induced pulmonary hemorrhage associated with antimyeloperoxidase-antineutrophil cytoplasmic antibody: a case report.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been recently recognized in Graves' disease patients treated with antithyroid drugs. We describe the case of an 18-year-old girl who developed antimyeloperoxidase ANCA (MPO-ANCA)-positive vasculitis manifesting as a skin lesion and hemoptysis with hypoxic respiratory failure after taking methimazole. An open lung biopsy was consistent with acute capillaritis. Both skin and sural nerve biopsy showed lymphocytic vasculitis. Administration of steroid and plasmapheresis produced a good clinical response.
Tsai
M H
MH
Department of Internal Medicine, En Chu Kong Hospital, Taiwan.
Chang
Y L
YL
Wu
V C
VC
Chang
C C
CC
Huang
T S
TS
D000293:Adolescent; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D013956:Antithyroid Agents / Q000009:adverse effects*; D001323:Autoantibodies / Q000032:analysis*; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D008713:Methimazole / Q000009:adverse effects*; D009195:Peroxidase / Q000276:immunology*; D017445:Skin Diseases, Vascular / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology; D014657:Vasculitis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000276:immunology
D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D001323:Autoantibodies; D008713:Methimazole; D009195:Peroxidase