Korean J Nephrol.  2004 Nov;23(6):997-1003.

Propylthiouracil-associated p-ANCA Positive Vasculitis with Focal Segmental Glomerulosclerosis

• Park YK
• Yun YW
• Sung SS
• Park US
• Park SH
• Woo JH
• Park JI
• Jang SJ
• Han SW
• Oh YH
• Park YW
• Park MH
• Kim HJ

Abstract

Antineutrophilic cytoplasmic antibody (ANCA) associated vasculitis has been reported in Graves' disease patients treated with propylthiouracil (PTU). In most cases, it's renal involvements has been known as crescentic glomerulonephritis. A 41-year-old female patient with hyperthyroidism has been treated with PTU for 3 years. The patient had developed isolated hematuria and polyarthralgia with p-ANCA positivity, 6 months and 10 months after PTU treatment, respectively. She had been continuously treated with PTU until she was admitted at our hospital. Three months before admission, polyarthralgia was aggravated and purpura in both lower legs and hands was developed. Urinalysis revealed hematuria, proteinuria. Serologic evaluation showed p-ANCA positive. Skin biopy showed leukocytoclastic vasculitis and renal biopsy showed focal segmental glomerulosclerosis (FSGS). She was diagnosed as PTU-associated vasculitis with FSGS. Polyarthralgia and purpura were improved after discontinuing the PTU with prednisolone treatment but hematuria, proteinuria were not changed. We suggest that progression of PTU-associated focal segmental necrotizing glomerulonephritis to FSGS over two years might be due to continued PTU medication.

Keyword

Propylthiouracil; p-ANCA; vasculitis; Focal segmental glomerulosclerosis

MeSH Terms

Adult
Antibodies, Antineutrophil Cytoplasmic*
Arthralgia
Biopsy
Cytoplasm
Female
Glomerulonephritis
Glomerulosclerosis, Focal Segmental*
Graves Disease
Hand
Hematuria
Humans
Hyperthyroidism
Leg
Prednisolone
Propylthiouracil
Proteinuria
Purpura
Skin
Urinalysis
Vasculitis*
Antibodies, Antineutrophil Cytoplasmic
Prednisolone
Propylthiouracil