Wiik Allan
Department of Autoimmunology, Statens Serum Institut, Copenhagen, Denmark.
Arthritis Res Ther. 2005;7(5):191-2. doi: 10.1186/ar1805. Epub 2005 Aug 24.
Clinical recognition of drug-induced vasculitic and lupus-like syndromes is very important because continued use of the offending drug can lead to irreversible and life-threatening vasculitic organ damage (e.g. end-stage renal disease or pulmonary haemorrhage). Withdrawal of the drug often leads to spontaneous recovery, meaning that immunosuppressive therapy can be avoided. The presence of myeloperoxidase-antineutrophil cytoplasmic antibodies, IgM anticardiolipin antibody, and antihistone antibodies in combination was found to be characteristic of drug-induced vasculitic syndromes caused by the antithyroid drugs propylthiouracil and methimazol. Clinically, skin vasculitis and arthralgias predominated and renal vasculitis was rare.
药物性血管炎和狼疮样综合征的临床识别非常重要,因为持续使用致病药物可导致不可逆转且危及生命的血管性器官损害(如终末期肾病或肺出血)。停用该药物通常会导致自发恢复,这意味着可以避免免疫抑制治疗。研究发现,髓过氧化物酶-抗中性粒细胞胞浆抗体、IgM抗心磷脂抗体和抗组蛋白抗体同时存在是由抗甲状腺药物丙硫氧嘧啶和甲巯咪唑引起的药物性血管炎综合征的特征。临床上,皮肤血管炎和关节痛较为常见,而肾血管炎则较为罕见。