Propylthiouracil-induced leucocytoclastic vasculitis with pulmonary hemorrhage treated with plasmapheresis.
Propylthiouracil (PTU) can effectuate antineutrophil cytoplasmic antibodies (ANCA)-positive vasculitis. We report a case of severe, PTU-induced leucocytoclastic vasculitis with diffuse pulmonary hemorrhage within a month of initiating PTU. Emergent plasmapheresis was initiated with excellent clinical response. A clinical suspicion for this potential side effect coupled with early cessation of the drug is generally adequate. Clinical manifestations, posited pathogenetic mechanisms, and therapeutic strategies, including the role of plasmapheresis, are discussed.
Irani
Farzan
F
Department of Internal Medicine, St. Vincent Mercy Medical Center, Toledo, Ohio, USA. farzan_i@yahoo.com
Elkambergy
Hussam
H
Naraharisetty
Kalpana
K
Jamal
Raheel
R
D000368:Aged; D013956:Antithyroid Agents / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000150:complications / Q000628:therapy; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000150:complications / Q000628:therapy; D010956:Plasmapheresis; D011441:Propylthiouracil / Q000009:adverse effects*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000150:complications / Q000628:therapy
D013956:Antithyroid Agents; D011441:Propylthiouracil