Aged ; Antibodies, Antineutrophil Cytoplasmic ; metabolism ; Female ; Humans ; Middle Aged ; Propylthiouracil ; adverse effects ; Vasculitis ; chemically induced ; metabolism

Adult ; Agranulocytosis ; chemically induced ; metabolism ; pathology ; Antibodies, Antineutrophil Cytoplasmic ; metabolism ; Bone Marrow Diseases ; chemically induced ; metabolism ; pathology ; Female ; Graves Disease ; drug therapy ; Humans ; Plasma Cells ; pathology ; Propylthiouracil ; adverse effects ; therapeutic use ; Vasculitis ; chemically induced ; immunology ; pathology

OBJECTIVETo observe the pathological changes in the blood vessels in rabbit femoral head with glucocorticoid-induced necrosis and investigate the pathogenesis of glucocorticoid-induced osteonecrosis.

METHODSTwenty New Zealand white rabbits were randomly divided into two groups, namely group A. which was injected with horse serum and prednisone and group B as the control group. Chinese ink was injected into the femoral cavity of the rabbits to observe the blood vessels in the femoral head under optical microscope and the femoral head was examined histopathologically.

RESULTSCompared with the normal control group, the rabbits in group A had significantly decreased number of perfused vessels, which was featured by defective perfusion, osteocytie pyknosis or necrosis, increase of empty ostoocyte lacunae and fat cells, decrease of hematopoietic tissue, and blood vessel occlusion.

CONCLUSIONVascular occlusion and vasculitis due to glucocorticoid treatment may cause avascular necrosis of the femoral head.

Animals ; Blood Vessels ; pathology ; Female ; Femur Head ; blood supply ; pathology ; Femur Head Necrosis ; chemically induced ; pathology ; Male ; Prednisolone ; Rabbits ; Random Allocation ; Vasculitis ; pathology

The relationship between immune vasculitis and atherosclerosis was studied. The experimental model of weanling rabbits for immune vasculitis was reproduced by intravenous injection of 10% bovine serum albumin. There were 6 groups: group A, 25 weanling rabbits with immune vasculitis subject to coronary arteriography; group B, 10 normal mature rabbits subject to coronary arteriography; group C, 10 weanling rabbits subject to coronary arteriography; group D, 8 weanling rabbits with vasculitis and cholesterol diet; group E, 8 weanling rabbits receiving single cholesterol diet; group F: 8 weanling rabbits receiving basic diet. Four weeks later, coronary arteriography was performed in groups A, B and C. The rabbits in groups D, E and F were sacrificed for the study of pathological changes in the coronary artery after 12 weeks. The results showed that the dilatation of coronary artery occurred in 6 rabbits of group A, but in groups B and C, no dilatation of coronary artery appeared. In comparison with group E, more severe atherosclerosis occurred in group D, showing the thickened plaque, fibrous sclerosis and atherosclerotic lesion. Percentage of plaques covering aortic intima, incidence of atherosclerosis of small coronary arteries and degree of stenosis of coronary arteries were significantly higher in group D than in group E (P < 0.01). No atherosclerosis changes were found in group F. It was concluded that in the acute phase, the serum immune vasculitis can induce the dilatation of coronary artery of some weanling rabbits, and aggravate the formation of atherosclerosis in rabbits fed with cholesterol diet. Immune vasculitis is a new risk factor of atherosclerosis and ischemic heart disease.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/chemically induced ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications ; Atherosclerosis/*etiology ; Cholesterol, Dietary/*administration & dosage ; Myocardial Ischemia/etiology ; Random Allocation ; Risk Factors ; Serum Albumin, Bovine

There has been an increase in the number of patients treated with pegylated interferon (PEG-IFN) and ribavirin due to the better antiviral efficacy. The main serious adverse events of PEG-IFN plus ribavirin combination therapy are bone marrow suppression and hemolytic anemia. However, there are few reports of vasculitis occurring during PEG-IFN therapy. We describe a patient who developed vasculitis during the treatment of chronic hepatitis C with PEG-IFN and ribavirin.
Antiviral Agents/*adverse effects ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/*adverse effects ; Liver Function Tests ; Middle Aged ; Polyethylene Glycols/*adverse effects ; Ribavirin/*adverse effects ; Skin/drug effects ; Vasculitis/*chemically induced

OBJECTIVEPropylthiouracil (PTU) as a drug used during the treatment of hyperthyroidism could induce antineutrophil cytoplasmic autoantibody-positive vasculitis. Here the author reported a childhood case of antineutrophil cytoplasmic autoantibody-positive vasculitis induced by PTU, which is rarely described.

METHODSThe diagnosis was made according to the symptoms, signs, serum markers and renal biopsy, and the relevant literature was reviewed.

RESULTSThe 12-year-old girl presented with gross hematuria, proteinuria, renal function damage [Ccr 52.46 ml/(min. 1.73 m(2))], positive antineutrophil cytoplasmic autoantibody (ANCA-MPO) (MPO ELISA 140%) and a vasculitis lesion in the renal biopsy sample. She had been treated with PTU for 5 years because of Graves disease. After the diagnosis, the PTU was withdrawn, and prednisone (40 mg/d) and cyclophosphamide (25 mg, Bid) were applied. Three weeks after the therapy with prednisone and cyclophosphamide the gross hematuria disappeared. Three months after the treatment the renal function returned to normal [Ccr 124 mg/(min.1.73 m(2))], and the titer of ANCA-MPO decreased from 140% to 57%.

CONCLUSIONPTU may induce antineutrophil cytoplasmic autoantibody positive vasculitis. A right diagnosis and treatment can improve its prognosis of the disease.

Antibodies, Antineutrophil Cytoplasmic ; blood ; Antithyroid Agents ; adverse effects ; therapeutic use ; Child ; Diagnosis, Differential ; Female ; Humans ; Hyperthyroidism ; drug therapy ; Prognosis ; Propylthiouracil ; adverse effects ; therapeutic use ; Treatment Outcome ; Vasculitis ; chemically induced ; diagnosis ; therapy

OBJECTIVETo study the relationship between methimazole (MMI) and antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis.

METHODSThirty-three cases with Graves' disease were tested for serum ANCA before and after taking MMI. At the same time, clinicopathological data of two patients with Graves' disease who had antineutrophil cytoplasmic antibody-positive vasculitis during treatment with MMI were analyzed.

RESULTSTwo patients developed antineutrophil cytoplasmic antibody-positive vasculitis during the medication with MMI for 5-6 years; their major clinical manifestations were hematuria and renal failure. Renal biology showed renal vasculitis and vascular necrosis. The disease was relieved after treatment with immunosuppressor. Serum ANCA in the 33 cases was negative before taking MMI. In 3 cases serum ANCA became positive after taking MMI for 2 months, 3 months and 2 years, respectively. The positive rate is 9% (3/33). The major finding was microscopic hematuria. ANCA positive rate was significantly higher after taking MMI than that before taking MMI (chi2) = 5.3, P < 0.05). Microscopic hematuria disappeared after general treatment.

CONCLUSIONThere may be a relationship between methimazole and development of antineutrophil cytoplasmic antibody-positive vasculitis. Renal impairment can occur. The signs and symptoms of the vasculitis can disappear after proper treatment.

Adolescent ; Antibodies, Antineutrophil Cytoplasmic ; blood ; Antithyroid Agents ; adverse effects ; therapeutic use ; Child ; Female ; Graves Disease ; drug therapy ; pathology ; Humans ; Kidney ; pathology ; Male ; Methimazole ; adverse effects ; therapeutic use ; Vasculitis ; chemically induced