[Benzylthiouracil induced ANCA-positive vasculitis].
BACKGROUND
Several cases of vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) have been reported in patients treated with synthetic anti-thyroid drugs but only 2 cases have incriminated benzylthiouracil.


METHODS
A 36 year-old woman, 3 years after treatment with benzylthiouracil, rapidly developed progressive kidney failure, related to a pauci-immune extra-capillary glomerular nephropathy and necrotic vasculitis lesions. The search for p-ANCA was positive with anti-myeloperoxidase specificity. She was treated with corticosteroids and 6 monthly intravenous pulses of cyclophosphamide substituted by azathioprine. Renal failure and proteinuria significantly improved. However the high level of p-ANCA.


CONCLUSIONS
ANCA vascularities are a rare but serious complication of treatment with synthetic thiouracile-type anti-thyroid drugs. The ANCA must be measured when confronted with a systemic manifestation during treatment.
Braham
Amel
A
Service de médecine interne, Hôpital La Rabta, Tunis, Tunisie.
Houman
Med Habib
MH
Rais
Lamia
L
Ben Gborbel
Imed
I
Lamloum
Mounir
M
Miled
Mohamed
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis / Q000276:immunology*; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D013889:Thiouracil / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D014543:Uridine Phosphorylase / Q000037:antagonists & inhibitors; D014657:Vasculitis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology*
D000305:Adrenal Cortex Hormones; D000974:Antibodies, Antinuclear; D013889:Thiouracil; D014543:Uridine Phosphorylase; C019269:benzylthiouracil