Korean J Intern Med.  2006 Dec;21(4):240-243. 10.3904/kjim.2006.21.4.240.

Diffuse Alveolar Hemorrhage Associated with Antineutrophil Cytoplasmic Antibody levels in a Pregnant Woman Taking Propylthiouracil

• Kang AY
• Baek YH
• Sohn YJ
• Lee SK
• Son CH
• Kim K
• Yang DK

• KMID: 759858
• DOI: http://doi.org/10.3904/kjim.2006.21.4.240

Abstract

Propylthiouracil (PTU) is known to be a potential cause of antineutrophil cytoplasmic antibody (ANCA) positive small vessel vasculitis, resulting in glomerulonephritis and diffuse alveolar hemorrhage (DAH). Herein, we describe a 25-year-old pregnant woman who developed a perinulcear ANCA (p-ANCA) and myeloperoxidase ANCA (MPO-ANCA) positive DAH during PTU therapy. The patient improved after corticosteroid therapy and discontinuation of the PTU. Methimazole was prescribed in spite of the risk of recurrence of DAH because of the pregnancy. The patient is currently free from pulmonary problems. Our case shows that the alternative agent, methimazole, can be used to treat hyperthyroidism in a pregnant patient with PTU associated DAH.

Keyword

Antineutrophil cytoplasmic antibody; Propylthiouracil

MeSH Terms

Tomography, X-Ray Computed
*Pulmonary Alveoli
Propylthiouracil/*adverse effects/therapeutic use
*Pregnancy Complications, Hematologic
Pregnancy
Hyperthyroidism/blood/complications/*drug therapy
Humans
Hemoptysis/*chemically induced/diagnosis/immunology
Female
Diagnosis, Differential
Bronchoscopy
Antithyroid Agents/*adverse effects/therapeutic use
Antibodies, Antineutrophil Cytoplasmic/*blood
Adult