Pantoprazole and perinuclear antineutrophil cytoplasmic antibody-associated vasculitis.
Systemic vasculitis may, at times, be drug-induced and associated with antineutrophil cytoplasmic antibodies (ANCA). However, pantoprazole, a commonly used and well-tolerated proton pump inhibitor, has not previously been reported to cause ANCA-associated syndromes. We describe a patient who developed interstitial nephritis, cutaneous vasculitis, a perinuclear ANCA staining pattern (pANCA) on immunofluorescence, and anti-myeloperoxidase antibodies (MPO-ANCA) in association with pantoprazole. We review various immune-mediated syndromes reported in association with proton pump inhibitors, including one report of omeprazole associated with interstitial nephritis and the development of ANCA.
Jacobs-Kosmin
Dana
D
Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Derk
Chris T
CT
Sandorfi
Nora
N
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000208:Acute Disease; D000368:Aged; D000897:Anti-Ulcer Agents / Q000009:adverse effects*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D001562:Benzimidazoles / Q000009:adverse effects*; D002467:Cell Nucleus / Q000276:immunology / Q000473:pathology*; D002908:Chronic Disease; D005076:Exanthema / Q000139:chemically induced / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000276:immunology / Q000628:therapy; D009853:Omeprazole / Q000009:adverse effects / Q000031:analogs & derivatives*; D000077402:Pantoprazole; D009195:Peroxidase / Q000276:immunology; D006435:Renal Dialysis; D013454:Sulfoxides / Q000009:adverse effects*; D016896:Treatment Outcome; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000276:immunology / Q000628:therapy
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D001562:Benzimidazoles; D013454:Sulfoxides; D000077402:Pantoprazole; D009195:Peroxidase; D009853:Omeprazole; D008775:Methylprednisolone