PMID- 27741122
OWN - NLM
STAT- MEDLINE
DCOM- 20170210
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 41
DP  - 2016 Oct
TI  - Possibly propylthiouracil-induced antineutrophilic cytoplasmic 
      antibody-associated vasculitis manifested as blood coagulation disorders: A case 
      report.
PG  - e5068
LID - 10.1097/MD.0000000000005068 [doi]
LID - e5068
AB  - BACKGROUND: Propylthiouracil is the most common drug used to treat 
      hyperthyroidism. However, this drug could cause a severe disease, 
      antineutrophilic cytoplasmic antibody-associated vasculitis (AAV), which was 
      usually misdiagnosed. METHODS: We reported a 60-year-old woman of 
      propylthiouracil-induced AAV manifested as blood coagulation disorders. The 
      patient was admitted because of hyperthyroidism and leukopenia. At the time of 
      hospitalization, she suffered from dry cough, erythema and knee joints ache, and 
      gradually became febrile. And then BP decreased and PLT was reduced with 
      coagulation disorders. ANCA: c-ANCA positive (1:100), p-ANCA positive (1:320), 
      MPO-IgG positive, PR3-IgG positive, GBM-IgG negative. Erythrocyte sedimentation 
      rate and C-reactive protein increased markedly. Chest high-resolution computed 
      tomography (HRCT) showed that scattered spots, patch and ground-glass opacity. 
      RESULTS: Finally, we made a terminal diagnosis of PTU-induced AAV possibly. After 
      drug withdrawal and use of steroid, the patient recovered well and then accepted 
      RAI therapy. As the patient was given imipenem-cilastatin before the reduction of 
      PLT and coagulation disorders, we considered that the hematologic disorders might 
      be caused by antibiotics or a clinical presentation of the vasculitis itself. 
      CONCLUSION: Drug-induced vasculitis is relatively good prognosis, but early 
      diagnosis and timely withdrawal of associated drugs are the key to the treatment.
FAU - Yi, Xiao-Yan
AU  - Yi XY
AD  - Department of Endocrinology Department of Traditional Chinese & Western Medicine, 
      the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, 
      China.
FAU - Wang, Yao
AU  - Wang Y
FAU - Li, Qi-Fu
AU  - Li QF
FAU - Li, Rong
AU  - Li R
FAU - Yang, Shu-Min
AU  - Yang SM
FAU - Zhou, Guo-Qing
AU  - Zhou GQ
FAU - Wang, Zhi-Hong
AU  - Wang ZH
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Antimetabolites)
RN  - 721M9407IY (Propylthiouracil)
SB  - IM
MH  - Antibodies, Antineutrophil Cytoplasmic/*blood
MH  - Antimetabolites/adverse effects
MH  - Blood Coagulation Disorders/*diagnosis
MH  - Diagnosis, Differential
MH  - Female
MH  - Graves Disease/drug therapy
MH  - Humans
MH  - Middle Aged
MH  - Propylthiouracil/*adverse effects
MH  - Tomography, X-Ray Computed
MH  - Vasculitis/blood/chemically induced/*diagnosis
PMC - PMC5072949
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/10/16 06:00
MHDA- 2017/02/12 06:00
PMCR- 2016/10/14
CRDT- 2016/10/15 06:00
PHST- 2016/10/15 06:00 [entrez]
PHST- 2016/10/16 06:00 [pubmed]
PHST- 2017/02/12 06:00 [medline]
PHST- 2016/10/14 00:00 [pmc-release]
AID - 00005792-201610110-00026 [pii]
AID - 10.1097/MD.0000000000005068 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Oct;95(41):e5068. doi: 10.1097/MD.0000000000005068.