Almeida Mariana S, Ramalho Carina, Gomes Francisco, Ginga Maria do Rosário, Vilchez José
Internal Medicine Department, Centro Hospitalar Barreiro Montijo, Barreiro, PRT.
Pathology Department, Centro Hospitalar Barreiro Montijo, Barreiro, PRT.
Cureus. 2022 Jul 20;14(7):e27073. doi: 10.7759/cureus.27073. eCollection 2022 Jul.
The use of propylthiouracil (PTU) is associated with the development of autoantibodies, namely, antineutrophil cytoplasmic antibodies (ANCAs), which are associated with the pathogenesis of ANCA-associated systemic vasculitis, most often related to the myeloperoxidase subtype (ANCA-MPO). The authors report the case of a 61-year-old woman on PTU for one year who was referred to Internal Medicine for a three-month evolution of painless non-blanching purple patches, non-pruriginous, involving the chest and legs. The autoimmunity revealed ANCA antibody positivity, with a cutaneous biopsy compatible with leukocytoclastic vasculitis/necrotizing vasculitis with involvement of small and medium-sized vessels. Clinical improvement was noted after the drug was discontinued, with the resolution of the analytical changes.
丙硫氧嘧啶(PTU)的使用与自身抗体的产生有关,即抗中性粒细胞胞浆抗体(ANCA),其与ANCA相关性系统性血管炎的发病机制有关,最常见的是与髓过氧化物酶亚型(ANCA-MPO)相关。作者报告了一例61岁女性,服用PTU一年,因无痛性非压之褪色的紫色斑块、无瘙痒、累及胸部和腿部三个月而转诊至内科。自身免疫检查显示ANCA抗体阳性,皮肤活检结果符合白细胞破碎性血管炎/坏死性血管炎,累及中小血管。停药后临床症状改善,化验指标变化也得到缓解。