Propylthiouracil-induced rapidly progressive glomerulonephritis associated with antineutrophil cytoplasmic autoantibodies. 1997

Y Kudoh, and S Kuroda, and K Shimamoto, and O Iimura
Kidney Unit, South-One Hospital, Sapporo, Japan.

We present a case study of a 52-year-old female patient with hyperthyroidism which had been diagnosed at the age of 35. However, the malfunction of thyroid had been poorly controlled. Thyroid function was returning to normal after the administration of propylthiouracil (PTU) 300 mg/day, however purpura appeared in both lower extremities. Renal function deteriorated rapidly, and the patient was admitted to our hospital. According to the biopsies, leukocytoclastic vasculitis in the skin was apparent, and crescent formation was observed in the glomerulus. Serological examination revealed positive antineutrophil cytoplasmic autoantibodies (ANCA) against proteinase 3 (Pr3) and myeloperoxidase (MPO). Antinuclear autoantibody was positive. After cessation of PTU and administration of prednisolone, the purpura disappeared and ANCA were becoming negative. Renal function recovered gradually. Thyroid function was kept within normal range using iodine solution. Thus, it is strongly suggested that PTU-induced rapidly progressive glomerulonephritis associated with ANCA.

UI MeSH Term Description Entries
D006980 Hyperthyroidism Hypersecretion of THYROID HORMONES from the THYROID GLAND. Elevated levels of thyroid hormones increase BASAL METABOLIC RATE. Hyperthyroid,Primary Hyperthyroidism,Hyperthyroidism, Primary,Hyperthyroids
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011441 Propylthiouracil A thiourea antithyroid agent. Propythiouracil inhibits the synthesis of thyroxine and inhibits the peripheral conversion of throxine to tri-iodothyronine. It is used in the treatment of hyperthyroidism. (From Martindale, The Extra Pharmacopeoia, 30th ed, p534) 6-Propyl-2-Thiouracil,6 Propyl 2 Thiouracil
D005260 Female Females
D005921 Glomerulonephritis Inflammation of the renal glomeruli (KIDNEY GLOMERULUS) that can be classified by the type of glomerular injuries including antibody deposition, complement activation, cellular proliferation, and glomerulosclerosis. These structural and functional abnormalities usually lead to HEMATURIA; PROTEINURIA; HYPERTENSION; and RENAL INSUFFICIENCY. Bright Disease,Kidney Scarring,Glomerulonephritides,Scarring, Kidney
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013956 Antithyroid Agents Agents that are used to treat hyperthyroidism by reducing the excessive production of thyroid hormones. Antithyroid Agent,Antithyroid Drug,Goitrogen,Goitrogens,Thyroid Antagonists,Antithyroid Drugs,Antithyroid Effect,Antithyroid Effects,Agent, Antithyroid,Agents, Antithyroid,Antagonists, Thyroid,Drug, Antithyroid,Drugs, Antithyroid,Effect, Antithyroid,Effects, Antithyroid
D019268 Antibodies, Antineutrophil Cytoplasmic Autoantibodies directed against cytoplasmic constituents of POLYMORPHONUCLEAR LEUKOCYTES and/or MONOCYTES. They are used as specific markers for GRANULOMATOSIS WITH POLYANGIITIS and other diseases, though their pathophysiological role is not clear. ANCA are routinely detected by indirect immunofluorescence with three different patterns: c-ANCA (cytoplasmic), p-ANCA (perinuclear), and atypical ANCA. ANCA,Anti-Neutrophil Cytoplasmic Autoantibodies,Anti-Neutrophil Cytoplasmic Autoantibody,Antineutrophil Cytoplasmic Antibodies,Neutrophil Cytoplasmic Autoantibodies,Neutrophil Cytoplasmic Autoantibody,c-ANCA,p-ANCA,Anti-Neutrophil Cytoplasmic Antibodies,Anti-Neutrophil Cytoplasmic Antibody,Antineutrophil Cytoplasmic Antibody,Anti Neutrophil Cytoplasmic Antibodies,Anti Neutrophil Cytoplasmic Antibody,Anti Neutrophil Cytoplasmic Autoantibodies,Anti Neutrophil Cytoplasmic Autoantibody,Antibody, Anti-Neutrophil Cytoplasmic,Antibody, Antineutrophil Cytoplasmic,Autoantibody, Anti-Neutrophil Cytoplasmic,Autoantibody, Neutrophil Cytoplasmic,Cytoplasmic Antibody, Anti-Neutrophil,Cytoplasmic Antibody, Antineutrophil,Cytoplasmic Autoantibody, Anti-Neutrophil,Cytoplasmic Autoantibody, Neutrophil,c ANCA,p ANCA

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