[Antineutrophil cytoplasmic autoantibody positive vasculitis induced by propylthiouracil: a case report].
OBJECTIVE
Propylthiouracil (PTU) as a drug used during the treatment of hyperthyroidism could induce antineutrophil cytoplasmic autoantibody-positive vasculitis. Here the author reported a childhood case of antineutrophil cytoplasmic autoantibody-positive vasculitis induced by PTU, which is rarely described.


METHODS
The diagnosis was made according to the symptoms, signs, serum markers and renal biopsy, and the relevant literature was reviewed.


RESULTS
The 12-year-old girl presented with gross hematuria, proteinuria, renal function damage [Ccr 52.46 ml/(min. 1.73 m(2))], positive antineutrophil cytoplasmic autoantibody (ANCA-MPO) (MPO ELISA 140%) and a vasculitis lesion in the renal biopsy sample. She had been treated with PTU for 5 years because of Graves disease. After the diagnosis, the PTU was withdrawn, and prednisone (40 mg/d) and cyclophosphamide (25 mg, Bid) were applied. Three weeks after the therapy with prednisone and cyclophosphamide the gross hematuria disappeared. Three months after the treatment the renal function returned to normal [Ccr 124 mg/(min.1.73 m(2))], and the titer of ANCA-MPO decreased from 140% to 57%.


CONCLUSIONS
PTU may induce antineutrophil cytoplasmic autoantibody positive vasculitis. A right diagnosis and treatment can improve its prognosis of the disease.
Zhang
Jing-jing
JJ
Department of Pediatric, Peking University First Hospital, Beijing 100034, China.
Chen
Ying-nan
YN
Xiao
Hui-jie
HJ
Liu
Jing-cheng
JC
Yang
Ji-yun
JY
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D011379:Prognosis; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome; D014657:Vasculitis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D011441:Propylthiouracil