Korean J Med.  2011 Sep;81(3):397-402.

A Case of MPO-ANCA Positive Vasculitis Associated with Pulmonary Nodules and Membranous Nephropathy Following Propylthiouracil Treatment

• Ryu KD
• Bae MJ
• Baek DH
• Shin MJ
• Seong EY
• Song SH
• Kwak IS

Abstract

Vasculitis is one of the rare complications of antithyroid drugs. In most cases, it is associated with ANCA and usually involves more than one organ. Renal involvement is the most common manifestation, and mainly presents as pauci-immune glomerulonephritis. We experienced MPO-ANCA-positive vasculitis and renal involvement presenting as membranous nephropathy following propylthiouracil (PTU) treatment. Cases of MPO-ANCA-positive vasculitis with membranous nephropathy are very uncommon, and the relationship between PTU and glomerulonephritis with immune complex deposition is unclear at present. A 58-year-old woman who had been treated with PTU for Graves' disease was admitted because of dyspnea and general edema. Chest computed tomography showed multiple nodules in both lung fields. The serum level of MPO-ANCA was positive. Initial laboratory findings included proteinuria, hematuria and increased serum creatinine. We thought that MPO-ANCA-associated vasculitis was induced by PTU and renal involvement. Renal biopsy revealed membranous nephropathy.

Keyword

Propylthiouracil; ANCA-associated vasculitis; Pulmonary nodule; Membranous nephropathy

MeSH Terms

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Antigen-Antibody Complex
Antithyroid Agents
Biopsy
Creatinine
Dyspnea
Edema
Female
Glomerulonephritis
Glomerulonephritis, Membranous
Graves Disease
Hematuria
Humans
Lung
Middle Aged
Propylthiouracil
Proteinuria
Thorax
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Antigen-Antibody Complex
Antithyroid Agents
Creatinine
Propylthiouracil