Necrotizing vasculitis in a patient affected by autoimmune hyperthyroidism treated with propylthiouracil.
Necrotizing vasculitis is a complex phenomenon because of an inflammation of small and larger vessels with polymorph infiltration within the vessel walls and leukocytoclasis, occurring in several autoimmune diseases. Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, but it is associated with various rare side effects, such as antineutrophil cytoplasm antibody-positive vasculitis. In the last decades, multiple cases of PTU causing antineutrophilic cytoplasmic antibody have been reported, some of them fatal. The present authors report the case of a 34-year-old Caucasian female affected by autoimmune hyperthyroidism treated with PTU, presenting an antineutrophil cytoplasm antibody-positive necrotizing vasculitis, with high levels of anticardiolipin antibodies that involved the upper arms and buttocks. The clinical manifestations improved after discontinuing of PTU and immunosuppressant treatment.
Antonucci
Angela
A
Department of Dermatology, University of Bologna, Bologna, Italy. av_antonucci@yahoo.it
Bardazzi
Federico
F
Iozzo
Ivano
I
Patrizi
Annalisa
A
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood / Q000276:immunology; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009336:Necrosis / Q000139:chemically induced / Q000188:drug therapy; D009504:Neutrophils / Q000276:immunology / Q000473:pathology; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy
D017153:Antibodies, Anticardiolipin; D013956:Antithyroid Agents; D007166:Immunosuppressive Agents; D011441:Propylthiouracil