title: PTU-associated vasculitis in a girl with Turner Syndrome and Graves' disease.
abstract: Palpable purpura is a concerning clinical finding in pediatric patients and can have many causes, including infectious and autoimmune processes. A rare cause, drug-induced vasculitis, may result from the production of antineutrophil cytoplasmic antibodies (ANCAs) in response to a medication. We report a girl with Turner syndrome and Graves' disease who presented with palpable purpuric lesions. The diagnosis of propylthiouracil (PTU)-associated vasculitis was made by observation of consistent clinical features, the detection of elevated ANA and ANCA in the blood, and the observed clinical resolution of symptoms following withdrawal of PTU. Subsequent treatment of persistent hyperthyroidism with radioablation did not result in an exacerbation of the vasculitis, a complication described in prior case reports.
authors.affiliation: Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4318, USA.
authors.forename: Olga T
authors.initials: OT
authors.lastname: Hardy
authors.forename: Kara N
authors.initials: KN
authors.lastname: Smolinski
authors.forename: Albert C
authors.initials: AC
authors.lastname: Yan
authors.forename: Adda
authors.initials: A
authors.lastname: Grimberg
mesh_terms: D013956:Antithyroid Agents / Q000009:adverse effects*; D002648:Child; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D011441:Propylthiouracil / Q000009:adverse effects*; D013974:Thyroxine / Q000627:therapeutic use; D014424:Turner Syndrome / Q000150:complications*; D014657:Vasculitis / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology
chemical_list: D013956:Antithyroid Agents; D011441:Propylthiouracil; D013974:Thyroxine