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[丙硫氧嘧啶诱发的抗中性粒细胞胞浆抗体(ANCA)相关自身免疫性疾病]

[Antineutrophil cytoplasmic antibody (Anca)-associated autoimmune disease induced by propylthiouracil].

作者信息

Pietszkowski Nádila Cecyn, Carvalho Gisah Amaral de, Souza Hevelyn Noemberg de, Werka Cláudio Rogério, Borazo Luís Augusto, Graf Hans, Carvalho Mauricio de

机构信息

Serviço de Endocrinologia e Metabologia, Universidade Federal do Paraná, Curitiba, PR.

出版信息

Arq Bras Endocrinol Metabol. 2007 Feb;51(1):136-41. doi: 10.1590/s0004-27302007000100022.

Abstract

Antithyroid drugs sometimes cause severe complications. Propylthiouracil (PTU) can be associated to ANCA positive vasculitis, most often related to myeloperoxidase subtype (ANCA-MPO). Our objective is to describe a female patient with Graves' disease, who developed PTU induced-autoimmune disease, with cutaneous, pulmonary, and renal lesions, associated with ANCA. Histopathological examination revealed diffuse pulmonary hemorrhage, and focal segmental glomerulosclerosis at the kidney biopsy. She was treated with systemic corticosteroid therapy and cyclophosphamide, with clinical improvement. This case highlights the need for greater awareness of this relatively rare adverse effect of propylthiouracil.

摘要

抗甲状腺药物有时会引起严重并发症。丙硫氧嘧啶(PTU)可与抗中性粒细胞胞浆抗体(ANCA)阳性血管炎相关,最常与髓过氧化物酶亚型(ANCA-MPO)有关。我们的目的是描述一名患有格雷夫斯病的女性患者,她发生了PTU诱导的自身免疫性疾病,伴有皮肤、肺部和肾脏病变,并与ANCA相关。组织病理学检查显示弥漫性肺出血,肾脏活检显示局灶节段性肾小球硬化。她接受了全身糖皮质激素治疗和环磷酰胺治疗,临床症状有所改善。该病例强调了需要提高对丙硫氧嘧啶这种相对罕见不良反应的认识。

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