Anti-Thyroid Drugs and Antincutrophil Cytoplasmic Antibody Positive Vasculitis. A Case Report and Review of the Literature

Gunton, JE; Stiel, J. N.; Caterson, Robyn J.; McElduff, Aidan

doi:10.1210/jcem.84.1.0013

Cited by 74 publications

(29 citation statements)

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“…The majority of ANCA-positive cases reported in association with antithyroid drugs in the literature are women, which has been attributed to the higher levels of thyrotoxicosis in women [5]. Similarly, in our study, most of the ANCA-positive patients were women (16/24, 67%).…”

Section: Discussionsupporting

confidence: 79%

“…When these adverse reactions are observed antithyroid drugs might be discontinued. In addition, antineutrophil cytoplasmic antibody (ANCA) positivity, ANCA-positive vasculitis, and ANCA-positive pyoderma gangrenosum have also been reported in association with PTU [2][3][4][5][6][7]. The development of central nervous system vasculitis with MMI treatment has also been described, resolving completely 6 months after cessation of treatment [8].…”

Section: Introductionmentioning

confidence: 99%

“…Graves' disease is the most frequent underlying thyroid disease in patients with ANCA-positive vasculitis associated with antithyroid medication [8,11,16,18,23]. On the other hand, ANCA positivity and ANCA-positive vasculitis have also been described for patients diagnosed with toxic multinodular goiter who were receiving antithyroid drug treatment [5,22].…”

Section: Introductionmentioning

confidence: 99%

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A comparison of antineutrophil cytoplasmic antibody prevalence in patients treated and untreated for hyperthyroidism

Çalhan

Şenateş

Cebeci³

et al. 2010

Endocr

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We aimed to compare the prevalence of antineutrophil cytoplasmic antibody (ANCA) and its subgroups between on-treatment (with anti-thyroid drugs; propylthiouracil, methimazole) and untreated patients with hyperthyroidism in our unit. Overall 78 consecutive patients were enrolled in the study; 45 patients were on-treatment (female/male 31:14) and 33 were newly diagnosed (female/male 20:13). We have studied ANCA, perinuclear-ANCA (p-ANCA), cytoplasmic-ANCA (c-ANCA), myeloperoxidase-ANCA (mpo-ANCA), and proteinase 3-ANCA (pr3-ANCA) in sera of all the patients. The data about clinical status, laboratory tests, and physical examination and mean duration of treatment in treated group were recorded. There was no statistically significant difference between the two groups for ANCA, c-ANCA, and pr3-ANCA (P=0.13, P=0.07, and P=0.63 respectively). p-ANCA and mpo-ANCA prevalences were significantly higher in on-treatment group than in untreated group (P=0.04 and P=0.01, respectively). The mean duration of treatment was 17 months in on-treatment group. The use of antithyroid drugs (propylthiouracil, methimazole) seems to be correlated with increased prevalence of ANCA. These drugs may especially increase p-ANCA and mpo-ANCA positivity.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A comparison of antineutrophil cytoplasmic antibody prevalence in patients treated and untreated for hyperthyroidism

Çalhan

Şenateş

Cebeci³

et al. 2010

Endocr

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“…These include not only dierent forms of vasculitis and other autoimmune diseases [14,15] but also hematologic disorders [17], drug-related reactions [18,19,20,21,22,23,24], and a variety of infectious diseases ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

Influenza A-associated bronchiolitis obliterans organizing pneumonia mimicking Wegener's granulomatosis

Staud

Ramos

2001

Rheumatol Int

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We describe a patient with bronchiolitis obliterans organizing pneumonia (BOOP) requiring respiratory support and treated with corticosteroids and cytoxan for presumed Wegener's granulomatosis (WG). The diagnosis of WG was based on clinical presentation and strongly positive stains for anti-neutrophilic cytoplasmic antibodies (cANCA). The results of an open-lung biopsy were consistent with BOOP. Although BOOP has previously been described as one of the pulmonary manifestations of WG, other more specific histologic features of WG such as capillaritis or necrotizing vasculitis were lacking. Because influenza A virus was cultured from the patient's lung tissue, final assessment of the illness focused on this as the etiologic agent triggering the pulmonary syndrome. The presence of ANCA was considered to be nonspecific. The patient's condition improved with appropriate therapy for BOOP.

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“…Among ANCA, anti-MPO autoantibodies (MPO-ANCA) are closely associated with microscopic polyangiitis, idiopathic pauci-immune necrotizing and crescentic glomerulonephritis (NCGN) and Churg-Strauss syndrome, whereas anti-PR3 autoantibodies (PR3-ANCA) are closely associated with Wegener's granulomatosis. [1][2][3] An increasing number of case reports on the complication of ANCA-associated vasculitis and/or pauci-immune NCGN in patients receiving 6-propyl-2-thiouracil (propylthiouracil, PTU) [4][5][6][7][8][9][10] suggests that ANCA may appear in patients with Graves' disease during PTU therapy. However, the incidence and significance of ANCA positivity in Graves' disease are still unclear.…”

Section: Introductionmentioning

confidence: 99%

Antineutrophil cytoplasmic antibodies in patients with Graves? disease: association of antimyeloperoxidase autoantibodies with propylthiouracil therapy

Honda¹,

Shibata²,

Hara³

et al. 2003

Modern Rheumatology

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Anti-Thyroid Drugs and Antincutrophil Cytoplasmic Antibody Positive Vasculitis. A Case Report and Review of the Literature

Cited by 74 publications

References 0 publications

A comparison of antineutrophil cytoplasmic antibody prevalence in patients treated and untreated for hyperthyroidism

A comparison of antineutrophil cytoplasmic antibody prevalence in patients treated and untreated for hyperthyroidism

Influenza A-associated bronchiolitis obliterans organizing pneumonia mimicking Wegener's granulomatosis

Antineutrophil cytoplasmic antibodies in patients with Graves? disease: association of antimyeloperoxidase autoantibodies with propylthiouracil therapy

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