PTU-associated vasculitis in a girl with Turner Syndrome and Graves' disease.
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.
Hardy
Olga T
OT
Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4318, USA.
Smolinski
Kara N
KN
Yan
Albert C
AC
Grimberg
Adda
A
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
D013956:Antithyroid Agents; D011441:Propylthiouracil; D013974:Thyroxine