- 期刊
Microscopic Polyangiitis Caused by Propylthiouracil in a Patient with Hyperthyroidism-A Case Report
甲狀亢進症病人使用PTU誘發Microscopic Polyangiitis的病例報告
摘要
咳血之病因主要細分為三類，包含呼吸道、肺實質性與肺血管性的疾病。而肺部之小血管炎，例如MPA，可廣泛影響肺實質。目前，導致MPA誘因之一的PTU，其致病機轉依然不清楚。 本篇提出一則服用PTU所誘發陽性ANCA的血管炎的病例。在本案例的治療上，我們給予機械性換氣及包括高劑量類固醇之脈衝療法，口服的免疫抑制劑(cyclophosphamide)併停止使用PTU。之後她的症狀好轉後出院，目前狀況穩定。
並列摘要
he etiology of hemoptysis can be grouped into 3 major categories: disease from the airways, the pulmonary parenchyma, and the pulmonary vasculature. Small vessel pulmonary vasculitis, such as microscopic polyangiitis (MPA), is 1 of the diseases diffusely affecting the pulmonary parenchyma in the presentation of the hemoptysis. Propylthiouracil (PTU) is 1 of the etiologies of MPA with an unclear mechanism. Herein, we describe a woman with PTU-induced ANCA-positive vasculitis who developed pulmonary hemorrhage with respiratory failure and crescentic glomerulonephritis. We initiated mechanical ventilation, and medical treatment, including highdose steroid pulse therapy and oral cyclophosphamide, and discontinued PTU. Her condition improved and she was discharged. She has been in stable condition without further sequelae.
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