A Case of ANCA-positive RPGN after Propylthiouracil Treatment.
- Author:
Gyung Won JUNG
1
;
Seong CHO
;
Sung Rok KIM
;
Oh Wen KWON
;
Jae Gon WOO
;
Ji Eun YI
Author Information
1. Department of Internal Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea. chaecho@kornet.net
- Publication Type:Case Report
- Keywords:
Propylthiouracil;
Glomerulonephritis;
ANCA
- MeSH:
Adult;
Antibodies, Antineutrophil Cytoplasmic;
Blood Pressure;
Creatinine;
Cyclophosphamide;
Female;
Fluorescent Antibody Technique;
Glomerulonephritis;
Graves Disease;
Hematuria;
Humans;
Light;
Microscopy;
Prognosis;
Propylthiouracil;
Proteinuria;
Stress, Psychological;
Urinalysis;
Vasculitis
- From:Korean Journal of Nephrology
2010;29(3):386-391
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Anti neutrophil cytoplasmic antibody (ANCA)-positive vasculitis and crescentic glomerulonephritis has been rarely reported in patients suffering from Graves' disease and treated with Propylthiouracil. We experienced a case of ANCA-positive crescentic glomerulonephritis presenting good prognosis after discontinuing Propylthiouracil. A 40-year-old female visited due to the proteinuria and hematuria in urinalysis. She had been medicated Propylthiouracil for 3 years. Blood pressure was 100/60 mmHg. BUN and serum creatinine were 24.7 mg/dL, and 1.9 mg/dL, respectively. Urinalysis revealed protein 1481 mg/day, many RBC's/HPF (dysmorphic 80%), Serological ANCA was positive, anti-myeloperoxidase (MPO) antibody 1,922 AAU/ mL (normal <150 AAU/mL). The histologic finding showed crescentic glomerulonephritis on light microscopy, but no immuno deposit on immunofluorescence and light microscopy. So we diagnosed ANCA positive pauci-immune glomerulonephritis. Propylthiouracil was discontinued and steroid, cyclophosphamide was medicated within about 1 month, but stopped due to cytopenia. Patient's creatinine level was maintained 1.3 mg/dL and showed stable progress for about over 18 months. We report this case that showed good prognosis after discontinuation of Propylthiouracil.
