title: Atypical propylthiouracil-induced ANCA-positive vasculitis: report of a case with unusual clinical and histopathologic findings.
abstract: The side effects of propylthiouracil, including cytopenia and vasculitis, are well established.  We present an interesting case in which cytopenia and cutaneous vasculopathy occurred concomitantly in a critically ill patient.  The patient was initially treated for suspected infection until dermatologic and rheumatologic workup revealed ANCA-positivity and vasculopathy on histopathology, most consistent with an atypical presentation of ANCA-positive vasculitis.  Upon initiation of immunosuppressive therapy, the patient's condition rapidly improved emphasizing the importance of early recognition of this condition.
authors.affiliation: Washington University School of Medicine; Barnes-Jewish Hospital. jmull@dom.wustl.edu.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Mull
authors.forename: Jason F
authors.initials: JF
authors.lastname: Solus
authors.forename: Misha M
authors.initials: MM
authors.lastname: Mutizwa
authors.forename: Herbert C
authors.initials: HC
authors.lastname: Chiang
authors.forename: Ilana S
authors.initials: IS
authors.lastname: Rosman
authors.forename: Amy
authors.initials: A
authors.lastname: Musiek
mesh_terms: D000328:Adult; D000855:Anorexia / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001768:Blister / Q000209:etiology; D005141:Eyelid Diseases / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D010198:Pancytopenia / Q000139:chemically induced; D010612:Pharyngitis / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D011441:Propylthiouracil / Q000009:adverse effects* / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D013956:Antithyroid Agents; D007166:Immunosuppressive Agents; D011441:Propylthiouracil; D011241:Prednisone; D008775:Methylprednisolone