Anti-Thyroid Drug-Induced ANCA-Associated Vasculitis. A Case Report and Review of the Literature.

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  • MORITA SHIGEKI
    Internal Medicine, Japanese Red Cross-Nagasaki Atomic Bomb Hospital
  • UEDA YASUO
    Internal Medicine, Japanese Red Cross-Nagasaki Atomic Bomb Hospital
  • EGUCHI KATSUMI
    First Department of Internal Medicine, Nagasaki University School of Medicine

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Abstract

We report a case of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis induced by propylthiouracil (PTU), and review the literature concerning to anti-thyroid drug-induced ANCA-associated vasculitis. A 45-year-old man treated with PTU developed fever and arthralgia without pulmonary, skin or eye involvement. These symptoms persisted for a long period without specific symptom, sign or laboratory data of other arthritis. Laboratory findings of urine and blood were normal, except for positive MPO-ANCA (191EU) and PR3-ANCA (37EU) findings. After PTU was discontinued without steroids or immune modulating drugs, both symptoms disappeared. Our patient had a high titer of MPO-ANCA. Moreover, titers of ANCA fell in correlation with the course of symptoms after the cessation of PTU, and we diagnosed PTU-induced ANCA-associated vasculitis. Most patients with pulmonary renal syndrome receive anti-thyroid drugs over a prolonged period, but the duration of our case was shorter than those of these patients. It is suggested that our patient was diagnosed at an early stage of ANCA-associated vasculitis before the start of pulmonary or renal involvement.

Journal

  • Endocrine Journal

    Endocrine Journal 47 (4), 467-470, 2000

    The Japan Endocrine Society

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