Elsevier

The Lancet

Volume 342, Issue 8872, 11 September 1993, Pages 651-652
The Lancet

Short report
Vasculitis and antineutrophil cytoplasmic autoantibodies associated with propylthiouracil therapy

https://doi.org/10.1016/0140-6736(93)91761-AGet rights and content

Abstract

Vasculitis is a rare complication of propylthiouracil therapy. Antineutrophil cytoplasmic antibodies (ANCA) have been described in association with several vasculitic disorders. We report detection of ANCA against human neutrophil elastase, proteinase 3, and myeloperoxidase in serum from six patients who developed evidence of vasculitis during propylthiouracil treatment of hyperthyroidism. On withdrawal of the drug ANCA concentrations fell and clinical symptoms resolved completely.

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    Citation Excerpt :

    As in drug-induced CSVV, the manifestations of ANCA-associated DIV may be skin limited40; however, patients may develop significant systemic involvement similar to idiopathic ANCA-associated vasculitis syndromes, such as granulomatosis with polyangiitis (Wegener granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (Churg-Strauss).25 Given the potential involvement of medium-sized vessels, the cutaneous presentation may also be characterized by necrotic ulcerations (Figure 7), subcutaneous nodules, livedo reticularis, and digital gangrene.25,54–57 In addition to nonspecific clinical manifestations, such as fever and arthralgias, patients may develop glomerulonephritis and pulmonary hemorrhage.25

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