Antineutrophil Cytoplasmic Autoantibody-Positive Crescentic Glomerulonephritis and Pulmonary Hemorrhage Associated with Propylthiouracil: A Case Report and Review of the Literature

血管炎為抗甲狀腺藥物之罕見併發症。曾有報告指出病患接受propylthiouracil (PTU)治療後，產生嗜中性白血球細胞質抗體(ANCA)陽性之血管炎。我們報告一位因服用PTU五年，產生pANCA陽性之血管炎，而有大量肺出血及免疫缺乏新月型腎絲球腎炎的女性病患。停用PTU合併給予類固醇脈衝治療後，此病患之臨床症狀即獲得改善。PTU是目前廣泛使用的抗甲狀腺藥物，病患可能會產生ANCA陽性之血管炎；臨床醫師必須警覺這種少見、卻具高致死性的不良藥物反應。

關鍵字

Propylthiouracil ；血管炎；嗜中性白血球細胞質抗體ANCA ；新月型腎絲球腎炎

並列摘要

Vasculitis is a rare complication of anti-thyroid drug treatment. Antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis has been described, especially in patients treated with propylthiouracil (PTU). We report a woman who developed vasculitis positive for perinuclear ANCA with massive pulmonary hemorrhage and pauci-immune crescentic glomerulonephritis after taking PTU for five years. Her clinical condition improved after withdrawing PTU followed by the administration of steroid pulse therapy. Since PTU is widely used for hyperthyroidism, clinicians should be aware of PTU-induced ANCA-positive vasculitis as a rare but potentially lethal adverse drug reaction.

並列關鍵字

propylthiouracil ； vasculitis ； ANCA ； crescentic glomerulonephritis

國際替代計量

Antineutrophil Cytoplasmic Autoantibody-Positive Crescentic Glomerulonephritis and Pulmonary Hemorrhage Associated with Propylthiouracil: A Case Report and Review of the Literature

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