Diffuse alveolar hemorrhage associated with antineutrophil cytoplasmic antibody levels in a pregnant woman taking propylthiouracil.
Propylthiouracil (PTU) is known to be a potential cause of antineutrophil cytoplasmic antibody (ANCA) positive small vessel vasculitis, resulting in glomerulonephritis and diffuse alveolar hemorrhage (DAH). Herein, we describe a 25-year-old pregnant woman who developed a perinulcear ANCA (p-ANCA) and myeloperoxidase ANCA (MPO-ANCA) positive DAH during PTU therapy. The patient improved after corticosteroid therapy and discontinuation of the PTU. Methimazole was prescribed in spite of the risk of recurrence of DAH because of the pregnancy. The patient is currently free from pulmonary problems. Our case shows that the alternative agent, methimazole, can be used to treat hyperthyroidism in a pregnant patient with PTU associated DAH.
Kang
Ah Young
AY
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Baek
Yang Hyun
YH
Sohn
You Jung
YJ
Lee
Soo-Keol
SK
Son
Choon Hee
CH
Kim
Kyeonghee
K
Yang
Doo Kyung
DK
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D006469:Hemoptysis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D011650:Pulmonary Alveoli; D014057:Tomography, X-Ray Computed
D019268:Antibodies, Antineutrophil Cytoplasmic; D013956:Antithyroid Agents; D011441:Propylthiouracil