title: Antineutrophil cytoplasmic antibody positive alveolar haemorrhage during propylthiouracil therapy for hyperthyroidism.
abstract: Recently, propylthiouracil (PTU) has been thought to be one of the possible causes of antineutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis syndrome, resulting in glomerulonephritis and, infrequently, diffuse alveolar haemorrhage (DAH). The mechanism of ANCA-positive vasculitis during PTU therapy is still unknown. Herein, we describe the case of a 59-year-old woman who developed myeloperoxidase (MPO)- and proteinase 3 (PR3)-ANCA positive DAH, without any other organ system involvement, during PTU therapy. Diminution and discontinuation of PTU resulted in a positive response. To our knowledge, this is the first documentation of both MPO- and PR3-ANCA-positive DAH, without systemic manifestations, developing during PTU therapy.
authors.affiliation: First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Sata
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Machiya
authors.forename: Daisuke
authors.initials: D
authors.lastname: Osaka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Wada
authors.forename: Shuichi
authors.initials: S
authors.lastname: Abe
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Otake
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism; D013956:Antithyroid Agents / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D008171:Lung Diseases / Q000139:chemically induced*; D042762:Methylophilaceae / Q000378:metabolism; D008875:Middle Aged; D053146:Myeloblastin; D011441:Propylthiouracil / Q000009:adverse effects*; D011650:Pulmonary Alveoli; D012697:Serine Endopeptidases / Q000378:metabolism
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D011441:Propylthiouracil; D012697:Serine Endopeptidases; D053146:Myeloblastin