Methimazole‐induced ANCA‐associated vasculitis with diffuse alveolar haemorrhage

Arai, Naoki; Nemoto, Kenji; Oh‐ishi, Shuji; Nonaka, Mizu; Hayashihara, Kenji; Saito, Takefumi

doi:10.1002/rcr2.315

Cited by 8 publications

(5 citation statements)

References 3 publications

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“… CD, HF Turan 2020 [ 21 ] abciximab HP, MI clopidogrel, aspirin, heparin. CD Seto 2011 [ 22 ] bevacizumab branch retinal vein occlusion, gastric cancer none diminish the regenerative capacity of endothelial cells Tahir 2015 [ 23 ] alemtuzumab RF, Alport syndrome, renal transplantation, methy prednisolone, chlorpheniramine, paracetamol Sepsis Ohtsuka 1997 [ 24 ] Propylthiouracil GD none AAV Yamauchi 2003 [ 25 ] Propylthiouracil GD, HP, hyperlipidaemia, Simvastatin, ethy icosapentate, amlodipine besilate AAV El-Fakih 2008 [ 26 ] Propylthiouracil GD none AAV Arai 2018 [ 27 ] methimazole GD none AAV Perri 2007 [ 28 ] azathioprine IPF, HP, CKD, bladder cancer Prednisone, beclomethasone inhalations, nadolol and hydrochlorothiazide Myelosuppression, thrombocytopenia, pneumonia Tanawuttiwat 2010 [ 29 ] Amiodarone AF, HP, AKI, rhabdomyolysis, intravenous hydration, metoprolol and warfarin PT, A...…”

Section: Discussionmentioning

confidence: 99%

Transient pulmonary and gastric bleeding after iopamidol administration in a patient with marginal zone lymphoma: a case report

Xu,

Chen,

Liu

et al. 2024

BMC Pulm Med

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Background Iopamidol is a non-ionic, water-soluble iodine contrast agent that is considered safe for intravenous or intra-arterial administration and is widely used both in the general population and in patients undergoing oncological treatment. While adverse reactions to iopamidol have been documented, to date, no pulmonary and gastric hemorrhages induced by iopamidol have been reported in oncology patients. We report the first case of this complication. Case presentation We report the case of a 60-year-old woman with marginal zone lymphoma who was receiving antineoplastic therapy. As part of the investigation for the condition, she underwent chest enhancement CT with iopamidol. Shortly thereafter(within five minutes), she experienced hemoptysis and hematemesis. She was intubated and admitted to the intensive care unit. Pre- and post-contrast images demonstrated the course of the hemorrhage. Flexible bronchoscopy and gastroscopy on the following day showed no active bleeding, and the patient recovered completely after antiallergy treatment. We speculate that contrast-induced hypersensitivity was the most likely cause of the transient pulmonary and gastric bleeding. Conclusion Although rare, the complications of iopamidol, which may cause allergic reactions in the lungs and stomach, should be considered.

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Section: Discussionmentioning

confidence: 99%

Transient pulmonary and gastric bleeding after iopamidol administration in a patient with marginal zone lymphoma: a case report

Xu,

Chen,

Liu

et al. 2024

BMC Pulm Med

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“…Other than vasculitis, commonly cited complications include arthritis, agranulocytosis, autoimmune hepatitis, cholestasis, hypoglycemia, pancreatitis, and hypoprothrombinemia [3]. The vasculitic process often involves kidneys and lungs [4, 5]. Other target organs include joints, muscles, nerves, or skin, with variable clinical presentation [3, 6].…”

Section: Discussionmentioning

confidence: 99%

Systemic p-ANCA vasculitis with fatal outcome, arising in the setting of methimazole use

Hacking¹,

Uppal

Khan

et al. 2019

CNCS

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Here we report a fatal case of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) due to methimazole use in a 64-year-old woman. She was initially hospitalized for abdominal pain and possible colitis, and subsequently developed hematuria, renal failure, and hemoptysis. The serologic work-up revealed positive antinuclear antibody (ANA) and perinuclear-antineutrophilic cytoplasm antibodies (p-ANCA), with positive antimyeloperoxidase. Three weeks following admission, the patient was found to be pulseless, and expired. At autopsy, microscopic review included widespread transmural necrotizing vasculitis and crescentic glomerulonephritis in the kidney, and diffuse pulmonary alveolar hemorrhage; focal coronary artery intimal vasculitis and necrotizing pericarditis were also noted. Several drugs have been associated with the development of ANCA-positive diseases, including propylthiouracil, hydralazine, allopurinol, penicillamine, and levamisole in cocaine. Association of ANCA vasculitis with methimazole exposure is less known, and severe presentation with fatal outcome, as seen in our patient, is exceedingly rare. We reviewed clinical and histopathologic features of drug-induced ANCA vasculitis associated with methimazole to raise awareness of this potentially life-threatening complication associated with this agent.

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“…Regarding vasculitis, a study reported an adverse reaction event of Methimazole-induced vasculitis [46]. Regarding hepatic failure, liver injury, and traumatic liver injury, existing research indicates that Methimazole can cause hepatotoxicity [44].…”

Section: Predicting the Drug-adr Associations For Methimazole And Pro...mentioning

confidence: 99%

Predicting Drugs Suspected of Causing Adverse Drug Reactions Using Graph Features and Attention Mechanisms

Yang,

Hu,

Zhang

et al. 2024

Pharmaceuticals

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Background: Adverse drug reactions (ADRs) refer to an unintended harmful reaction that occurs after the administration of a medication for therapeutic purposes, which is unrelated to the intended pharmacological action of the drug. In the United States, ADRs account for 6% of all hospital admissions annually. The cost of ADR-related illnesses in 2016 was estimated at USD 528.4 billion. Increasing the awareness of ADRs is an effective measure to prevent them. Assessing suspected drugs in adverse events helps to enhance the awareness of ADRs. Methods: In this study, a suspect drug assisted judgment model (SDAJM) is designed to identify suspected drugs in adverse events. This framework utilizes the graph isomorphism network (GIN) and an attention mechanism to extract features based on patients’ demographic information, drug information, and ADR information. Results: By comparing it with other models, the results of various tests show that this model performs well in predicting the suspected drugs in adverse reaction events. ADR signal detection was conducted on a group of cardiovascular system drugs, and case analyses were performed on two classic drugs, Mexiletine and Captopril, as well as on two classic antithyroid drugs. The results indicate that the model can accomplish the task of predicting drug ADRs. Validation using benchmark datasets from ten drug discovery domains shows that the model is applicable to classification tasks on the Tox21 and SIDER datasets. Conclusions: This study applies deep learning methods to construct the SDAJM model for three purposes: (1) identifying drugs suspected to cause adverse drug events (ADEs), (2) predicting the ADRs of drugs, and (3) other drug discovery tasks. The results indicate that this method can offer new directions for research in the field of ADRs.

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Methimazole‐induced ANCA‐associated vasculitis with diffuse alveolar haemorrhage

Cited by 8 publications

References 3 publications

Transient pulmonary and gastric bleeding after iopamidol administration in a patient with marginal zone lymphoma: a case report

Transient pulmonary and gastric bleeding after iopamidol administration in a patient with marginal zone lymphoma: a case report

Systemic p-ANCA vasculitis with fatal outcome, arising in the setting of methimazole use

Predicting Drugs Suspected of Causing Adverse Drug Reactions Using Graph Features and Attention Mechanisms

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