Propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis with glomeru-lonephritis
10.3760/cma.j.issn.1008-5734.2015.02.022
- VernacularTitle:丙硫氧嘧啶诱发抗中性粒细胞胞质抗体相关性血管炎致肾小球肾炎
- Author:
Zongfei JI
1
;
Lindi JIANG
1
Author Information
1. 复旦大学风湿 免疫 过敏性疾病研究中心/复旦大学附属中山医院风湿免疫科, 上海,200032
- Publication Type:Journal Article
- Keywords:
Propylthiouracil;
Anti-neutrophil cytoplasmic antibody-associated vasculitis;
Glomerulonephritis
- From:
Adverse Drug Reactions Journal
2015;(2):146-147
- CountryChina
- Language:Chinese
-
Abstract:
A 23-year-old woman took propylthiouracil( 50 mg in the morning and 25 mg at night alternates with 50 mg in the morning)and levothyroxine sodium(12. 5 mg once daily)for Grave's disease. Three years later,the patient presented with urine occult blood,however,her symptoms did not attract attention. Five months later,the patient developed soy-colored urine and vague pain in the left lower quadrant of the abdomen. Laboratory examination showed the following results:urine protein( ++),red blood cell( ++++),white blood cell( +),perinuclear anti-neutrophil cytoplasmic antibodies( ANCA) ( +),cytoplasmic ANCA( +),proteinase 3(PR3)27. 9 RU/ml,myeloperoxidase(MPO)>200 RU/ml. She was considered as PTU-induced ANCA associated vasculitis with glomerulonephritis and urinary tract infection. PTU and levothyroxine sodium were stopped. Her chest CT scan exhibited interspersed inflamma-tion,and kidney biopsy result further verified vasculitis. She received methylprednisolone pulse therapy and mycophenolate mofetil. After 7 months,her urine routine test showed normal results,perinuclear ANCA ( +),cytoplasmic ANCA( -),MPO >200 RU/ml,and PR3 was 2. 0 RU/ml. her laboratory results showed perinuclear ANCA( +),MPO 143 RU/ml 23 months later.
