Propylthiouracil-associated p-ANCA Positive Vasculitis with Focal Segmental Glomerulosclerosis.
- Author:
Yoon Kyung PARK
1
;
Yeo Wook YUN
;
Sang Suk SUNG
;
Ui Soon PARK
;
Sung Hyun PARK
;
Jin Hyun WOO
;
Jae Il PARK
;
Sun Joo JANG
;
Sang Woong HAN
;
Young Ha OH
;
Yong Wook PARK
;
Moon Hyang PARK
;
Ho Jung KIM
Author Information
1. Department of Internal Medicine, Hanyang University, College of Medicine, Seoul, Korea. kimhj@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Propylthiouracil;
p-ANCA;
vasculitis;
Focal segmental glomerulosclerosis
- MeSH:
Adult;
Antibodies, Antineutrophil Cytoplasmic*;
Arthralgia;
Biopsy;
Cytoplasm;
Female;
Glomerulonephritis;
Glomerulosclerosis, Focal Segmental*;
Graves Disease;
Hand;
Hematuria;
Humans;
Hyperthyroidism;
Leg;
Prednisolone;
Propylthiouracil;
Proteinuria;
Purpura;
Skin;
Urinalysis;
Vasculitis*
- From:Korean Journal of Nephrology
2004;23(6):997-1003
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Antineutrophilic cytoplasmic antibody (ANCA) associated vasculitis has been reported in Graves' disease patients treated with propylthiouracil (PTU). In most cases, it's renal involvements has been known as crescentic glomerulonephritis. A 41-year-old female patient with hyperthyroidism has been treated with PTU for 3 years. The patient had developed isolated hematuria and polyarthralgia with p-ANCA positivity, 6 months and 10 months after PTU treatment, respectively. She had been continuously treated with PTU until she was admitted at our hospital. Three months before admission, polyarthralgia was aggravated and purpura in both lower legs and hands was developed. Urinalysis revealed hematuria, proteinuria. Serologic evaluation showed p-ANCA positive. Skin biopy showed leukocytoclastic vasculitis and renal biopsy showed focal segmental glomerulosclerosis (FSGS). She was diagnosed as PTU-associated vasculitis with FSGS. Polyarthralgia and purpura were improved after discontinuing the PTU with prednisolone treatment but hematuria, proteinuria were not changed. We suggest that progression of PTU-associated focal segmental necrotizing glomerulonephritis to FSGS over two years might be due to continued PTU medication.
