Antineutrophil cytoplasmic antibody positive alveolar haemorrhage during propylthiouracil therapy for hyperthyroidism.
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.
Yamauchi
Keiko
K
First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
Sata
Makoto
M
Machiya
Jun-Ichi
J
Osaka
Daisuke
D
Wada
Toshihiro
T
Abe
Shuichi
S
Otake
Kazuhisa
K
Kubota
Isao
I
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
D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D011441:Propylthiouracil; D012697:Serine Endopeptidases; D053146:Myeloblastin