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2016 ; 18
(4
): e23320
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Propylthiouracil-Induced Vasculitis With Alveolar Hemorrhage Confirmed by
Clinical, Laboratory, Computed Tomography, and Bronchoscopy Findings: A Case
Report and Literature Review
#MMPMID27257510
Chen B
; Yang X
; Sun S
; Guo W
; Li X
; Zhang L
; Guo Z
; Han J
; Li N
Iran Red Crescent Med J
2016[Apr]; 18
(4
): e23320
PMID27257510
show ga
INTRODUCTION: Propylthiouracil (PTU) is commonly used to treat hyperthyroidism
and can induce antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis.
Although this is a rare side effect, ANCA-associated vasculitis can progress to
severe disease if its diagnosis and treatment are delayed, leading to a poor
prognosis. CASE PRESENTATION: A 43-year-old woman with Graves' disease developed
pulmonary vasculitis and diffuse alveolar hemorrhage (DAH) associated with ANCA
against myeloperoxidase and proteinase-3 that was confirmed by computed
tomography (CT) and bronchoscopy and treated with PTU. The symptoms and signs of
alveolar hemorrhage were rapidly resolved after PTU withdrawal and treatment with
corticosteroids. After 6 months of follow-up, the patient maintained complete
ANCA-negative clinical remission status, as confirmed by normal CT and
bronchoscopy findings. To our knowledge, this is the first documented case of
bronchoscopic comparison of PTU-induced DAH before and after steroid treatment.
CONCLUSIONS: Patients treated with PTU should be closely monitored and followed
up, even if the drug has been used for several years. When patients develop
progressive dyspnea with alveolar opacities on chest imaging that cannot be
explained otherwise, alveolar hemorrhage should be an important differential
diagnosis while investigating the case. Early diagnosis and prompt
discontinuation of the PTU treatment are essential for improving patient
outcomes.