PROPYLTHIOURACIL-INDUCED VASCULITIS WITH ALVEOLAR HEMORRHAGE CONFIRMED BY CLINICAL, LABORATORY, COMPUTED TOMOGRAPHY, AND BRONCHOSCOPY FINDINGS: A CASE REPORT AND LITERATURE REVIEW

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BO CHEN; YANG XIAOQING; SUN SHIHAI; GUO WEINA; LI XIAOSHENG; ZHANG LEI; GUO ZHONGLIANG; HAN JIE; LI NING

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Journal: Iranian Red Crescent Medical Journal Year:2016 | Volume:18 | Issue:4 Page(s): 0-0

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Title

PROPYLTHIOURACIL-INDUCED VASCULITIS WITH ALVEOLAR HEMORRHAGE CONFIRMED BY CLINICAL, LABORATORY, COMPUTED TOMOGRAPHY, AND BRONCHOSCOPY FINDINGS: A CASE REPORT AND LITERATURE REVIEW

Author(s)

Keywords

VASCULITIS

ANTINEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA)

THYROID DISEASE

GRAVES’ DISEASE

Abstract

Introduction: Propylthiouracil (PTU) is commonly used to treat hyperthyroidism and can induce antineutrophil cytoplasmic antibody (ANCA) -associated VASCULITIS. Although this is a rare side effect, ANCA-associated VASCULITIS can progress to severe disease if its diagnosis and treatment are delayed, leading to a poor prognosis.Case Presentation: A 43-year-old woman with GRAVES’ DISEASE developed pulmonary VASCULITIS and diffuse alveolar hemorrhage (DAH) associated with ANCA against myeloperoxidase and proteinase-3 that was confirmed by computed tomography (CT) and bronchoscopy and treated with PTU. The symptoms and signs of alveolar hemorrhage were rapidly resolved after PTU withdrawal and treatment with corticosteroids. After 6 months of follow-up, the patient maintained complete ANCA-negative clinical remission status, as confirmed by normal CT and bronchoscopy findings. To our knowledge, this is the first documented case of bronchoscopic comparison of PTU-induced DAH before and after steroid treatment.Conclusions: Patients treated with PTU should be closely monitored and followed up, even if the drug has been used for several years. When patients develop progressive dyspnea with alveolar opacities on chest imaging that cannot be explained otherwise, alveolar hemorrhage should be an important differential diagnosis while investigating the case. Early diagnosis and prompt discontinuation of the PTU treatment are essential for improving patient outcomes.

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References

SPONTANEOUS REMISSION OF ENCEPHALOPATHY ASSOCIATED WITH AUTOIMMUNE THYROID DISEASE IN A PATIENT WITH GRAVES' DISEASE: A RARE OCCURRENCE IN A RARE CLINICAL PICTURE

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APA: Copy

BO, CHEN, YANG, XIAOQING, SUN, SHIHAI, GUO, WEINA, LI, XIAOSHENG, ZHANG, LEI, GUO, ZHONGLIANG, HAN, JIE, & LI, NING. (2016). PROPYLTHIOURACIL-INDUCED VASCULITIS WITH ALVEOLAR HEMORRHAGE CONFIRMED BY CLINICAL, LABORATORY, COMPUTED TOMOGRAPHY, AND BRONCHOSCOPY FINDINGS: A CASE REPORT AND LITERATURE REVIEW. IRANIAN RED CRESCENT MEDICAL JOURNAL (IRCMJ), 18(4), 0-0. SID. https://sid.ir/paper/293225/en

Vancouver: Copy

BO CHEN, YANG XIAOQING, SUN SHIHAI, GUO WEINA, LI XIAOSHENG, ZHANG LEI, GUO ZHONGLIANG, HAN JIE, LI NING. PROPYLTHIOURACIL-INDUCED VASCULITIS WITH ALVEOLAR HEMORRHAGE CONFIRMED BY CLINICAL, LABORATORY, COMPUTED TOMOGRAPHY, AND BRONCHOSCOPY FINDINGS: A CASE REPORT AND LITERATURE REVIEW. IRANIAN RED CRESCENT MEDICAL JOURNAL (IRCMJ)[Internet]. 2016;18(4):0-0. Available from: https://sid.ir/paper/293225/en

IEEE: Copy

CHEN BO, XIAOQING YANG, SHIHAI SUN, WEINA GUO, XIAOSHENG LI, LEI ZHANG, ZHONGLIANG GUO, JIE HAN, and NING LI, “PROPYLTHIOURACIL-INDUCED VASCULITIS WITH ALVEOLAR HEMORRHAGE CONFIRMED BY CLINICAL, LABORATORY, COMPUTED TOMOGRAPHY, AND BRONCHOSCOPY FINDINGS: A CASE REPORT AND LITERATURE REVIEW,” IRANIAN RED CRESCENT MEDICAL JOURNAL (IRCMJ), vol. 18, no. 4, pp. 0–0, 2016, [Online]. Available: https://sid.ir/paper/293225/en

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