Tanaka Rika, Shimojima Yasuhiro, Moteki Hideaki, Kishida Dai, Ueno Ken-Ichi, Sekijima Yoshiki
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
Department of Otorhinolaryngology, Shinshu University School of Medicine, Japan.
Intern Med. 2018 Oct 15;57(20):3029-3033. doi: 10.2169/internalmedicine.0944-18. Epub 2018 May 18.
We herein report a case of otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) induced by propylthiouracil (PTU). A 30-year-old Japanese woman with Graves' disease, who was treated with PTU, reported with otitis media with sensorineural hearing loss bilaterally and trigeminal neuralgia on the left side, as well as elevated serum levels of myeloperoxidase-ANCA. Prior treatment with antibiotics was ineffective even after tympanostomy. However, clinical remission was immediately achieved after initiating prednisolone together with PTU withdrawal. These findings suggest that PTU therapy induces localized otological involvement as the concept of OMAAV.
我们在此报告一例由丙硫氧嘧啶（PTU）诱发的伴抗中性粒细胞胞浆抗体（ANCA）相关性血管炎的中耳炎（OMAAV）病例。一名30岁患有格雷夫斯病且接受PTU治疗的日本女性，出现双侧伴感音神经性听力损失的中耳炎及左侧三叉神经痛，同时血清髓过氧化物酶-ANCA水平升高。即使在鼓膜造孔术后，先前使用抗生素的治疗也无效。然而，在开始使用泼尼松龙并停用PTU后，临床症状立即缓解。这些发现表明，PTU治疗可诱发局部耳部受累，即OMAAV这一概念。
