Propylthiouracil-induced lupus-like syndrome developing in a Graves' patient with a sibling with systemic lupus erythematosus.
A 13-year-old girl with Graves' disease, whose younger sister had systemic lupus erythematosus, developed polyarthralgia, fever, neutropenia, hypergammaglobulinemia, and microscopic hematuria after treatment with propylthiouracil (PTU) for 2 years. Myeloperoxidase-anti-neutrophil cytoplasmic antibodies were strongly positive. Anti-single- and anti-double-stranded DNA antibodies were positive, whereas LE cells and anti-Sm antibodies were negative. PTU was discontinued and all symptoms subsided gradually. Two years later, the microscopic hematuria had disappeared completely. Both patients had the identical HLA-DR alleles (HLA-DR9). These present two cases in siblings suggest that both sisters had lupus diathesis, and that the elder sister developed a PTU-induced lupus-like syndrome.
Yamada
Akemi
A
Institute of Clinical Endocrinology, Tokyo Women's Medical University, Tokyo.
Sato
Kanji
K
Hara
Mitsuhiko
M
Tochimoto
Akiko
A
Takagi
Sachiko
S
Hizuka
Naomi
N
Takano
Kazue
K
D000293:Adolescent; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D013956:Antithyroid Agents / Q000009:adverse effects*; D005260:Female; D020022:Genetic Predisposition to Disease; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy*; D006684:HLA-DR Antigens / Q000235:genetics; D059810:HLA-DR Serological Subtypes; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000235:genetics / Q000276:immunology; D011441:Propylthiouracil / Q000009:adverse effects*; D035781:Siblings
D019268:Antibodies, Antineutrophil Cytoplasmic; D000974:Antibodies, Antinuclear; D013956:Antithyroid Agents; D006684:HLA-DR Antigens; D059810:HLA-DR Serological Subtypes; C038988:HLA-DR9 antigen; D011441:Propylthiouracil