Wada Norio, Mukai Masaya, Kohno Michifumi, Notoya Atsushi, Ito Tomohiro, Yoshioka Narihito
Division of Endocrinology and Metabolism, Department of Medicine, Sapporo City General Hospital, Kita-11, Nishi-13, Chuo-Ku, Sapporo 060-8604, Japan.
Endocr J. 2002 Jun;49(3):329-34. doi: 10.1507/endocrj.49.329.
Patients with Graves' disease (n = 61) treated with propylthiouracil (PTU) or thiamazole (MMI) were studied retrospectively to investigate differences in the prevalence of anti-myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) in relation to treatment with anti-thyroid drugs. The patients were divided into two groups: PTU-treated group (n = 32) and MMI-treated group (n = 29). There were no significant differences between the two groups in terms of age, gender distribution, or duration of treatment. In the PTU group, 8/32 (25%) patients were positive for MPO-ANCA, whereas in the MMI group, 1/29 (3.4%) patients were positive. There were no significant differences in age, duration, or dosage between the MPO-ANCA positive and negative patients. Most of the MPO-ANCA positive patients were asymptomatic, except for two patients in whom rheumatic arthritis or membranous glomerulonephritis developed. None of the MPO-ANCA positive patients were diagnosed as having classical ANCA-associated vasculitis. Thus, there is a high frequency of MPO-ANCA in patients with Graves' disease treated with PTU, compared with patients treated with MMI, although classical ANCA-associated vasculitis develops in only a few MPO-ANCA positive patients.
对接受丙硫氧嘧啶（PTU）或甲巯咪唑（MMI）治疗的格雷夫斯病患者（n = 61）进行回顾性研究，以调查抗甲状腺药物治疗相关的抗髓过氧化物酶抗中性粒细胞胞浆抗体（MPO - ANCA）患病率差异。患者分为两组：PTU治疗组（n = 32）和MMI治疗组（n = 29）。两组在年龄、性别分布或治疗持续时间方面无显著差异。在PTU组中，8/32（25%）的患者MPO - ANCA呈阳性，而在MMI组中，1/29（3.4%）的患者呈阳性。MPO - ANCA阳性和阴性患者在年龄、病程或剂量方面无显著差异。大多数MPO - ANCA阳性患者无症状，除了两名发生风湿性关节炎或膜性肾小球肾炎的患者。没有MPO - ANCA阳性患者被诊断为患有经典的ANCA相关血管炎。因此，与接受MMI治疗的患者相比，接受PTU治疗的格雷夫斯病患者中MPO - ANCA的频率较高，尽管只有少数MPO - ANCA阳性患者发生经典的ANCA相关血管炎。
