Propylthiouracil-induced microscopic polyangiitis

被引:2
作者
Seligman, VA
Bolton, PB
Sanchez, HC
Fye, KH [1 ]
机构
[1] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Pathol, San Francisco, CA 94143 USA
关键词
propylthiouracil; Grave's disease; vasculitis; microscopic polyangiitis; antineutrophil cytoplasmic antibodies; Wegener's granulomatosis; intra-alveolar hemorrhage;
D O I
10.1097/00124743-200106000-00007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The use of propylthiouracil (PTU) has been associated with various forms of vasculitis. We herein describe the case of a patient with Grave's disease who, after years of PTU therapy, developed a necrotizing vasculitis with anti-serine protease-3 antibodies. Despite treatment with corticosteroids and cyclophosphamide, the patient died of intra-alveolar hemorrhage secondary to her vasculitis. Based on the vessel size involved, the organ distribution of pathologic findings, and lack of granulomas, autopsy findings were felt to be more consistent with microscopic polyangiitis (MPA) than with. her original clinical diagnosis of Wegener's granulomatosis. Her case satisfied both clinical and pathologic criteria for MPA. An MPA diagnosis is important to consider in similar clinical presentations because therapy may just need to be early withdrawal of an inciting drug, such as PTU, and the initiation of corticosteroids without cytotoxic therapy.
引用
收藏
页码:170 / 174
页数:5
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