title: Propylthiouracil-induced antineutrophil cytoplasmic antibody (ANCA)-associated renal vasculitis versus primary ANCA-associated renal vasculitis: a comparative study.
abstract: OBJECTIVE
  Renal involvement is frequently present in primary antineutrophil cytoplasmic antibody-associated small-vessel vasculitis (AAV) as well as propylthiouracil (PTU)-induced AAV. We analyzed the characteristics of patients with PTU-induced AAV with renal involvement and investigated the differences of the 2 diseases.
  
  
  METHODS
  Thirty-six patients with PTU-induced AAV, diagnosed from 1997 to 2010, were enrolled for study. Their data were compared with those of 174 patients with primary AAV diagnosed at the same time. Renal involvement was present in all patients.
  
  
  RESULTS
  There was a prominent proportion of young women with PTU-induced AAV (p < 0.01). They had lower levels of proteinuria and serum creatinine and higher estimated glomerular filtration rate (p < 0.01, p < 0.01, and p < 0.01, respectively). Clinical immunological abnormalities were less severe in patients with PTU-induced AAV. Patients with PTU-induced AAV had less organ involvement and lower Birmingham Vasculitis Assessment Score than patients with primary AAV (p < 0.01). Renal biopsies showed a lower proportion of glomeruli with crescents (p < 0.01). Interstitial inflammation was less severe in patients with PTU-induced AAV (p < 0.05). Similarly, interstitial fibrosis and tubular atrophy were less severe in patients with PTU-induced AAV (p < 0.01, p < 0.05, respectively). Renal survival and total survival were better in patients with PTU-associated vasculitis (p < 0.05, p = 0.01).
  
  
  CONCLUSIONS
  Clinical and histopathological abnormalities were less severe in patients with PTU-induced AAV and most of them had a good prognosis.
authors.affiliation: Department of Nephrology, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025, PR China.
authors.forename: Yong-Xi
authors.initials: YX
authors.lastname: Chen
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.forename: Xiao-Nong
authors.initials: XN
authors.lastname: Chen
authors.forename: Hai-Jin
authors.initials: HJ
authors.lastname: Yu
authors.forename: Li-Yan
authors.initials: LY
authors.lastname: Ni
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.forename: Xiao-Xia
authors.initials: XX
authors.lastname: Pan
authors.forename: Hong
authors.initials: H
authors.lastname: Ren
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000139:chemically induced* / Q000401:mortality / Q000473:pathology*; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D005260:Female; D005355:Fibrosis; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D015996:Survival Rate; D013959:Thyroid Diseases / Q000188:drug therapy; D055815:Young Adult
chemical_list: D013956:Antithyroid Agents; D011441:Propylthiouracil; D003404:Creatinine