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.
Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Dana
D
Jacobs-Kosmin
Chris T
CT
Derk
Nora
N
Sandorfi
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