Propylthiouracil-induced Anti-neutrophil Cytoplasmic Antibodies and Agranulocytosis together with Granulocyte Colony-stimulating Factor Induced Sweet's Syndrome in a Patient with Graves' Disease

Sweet's Syndrome Associated with Graves' Disease

“…ANCA was positive after using PTU in all three cases, suggesting a pathogenic role of PTU-induced ANCA in Sweet's syndrome. [7][8][9] The present patient developed fever, skin rash, arthralgia, acroparesthesia after initiation of MMI and be- Sweet's syndrome are potentially able to affect thyroid gland. 6,13) In conclusion, clinicians should be aware of very rare associations with Sweet's syndrome and autoimmune thyroid disease, including Graves' disease or rare adverse effects of PTU but not MMI.…”

“…Only three cases have been reported in the literature, two reports by PTU and one report by G-CSF. [7][8][9] The first case was a 37-year-old woman who had been diagnosed with Graves' disease three years ago. 7) She was treated with PTU without any problems for the first two years.…”

“…8) She was treated with G-CSF for agranulocytosis and developed Sweet's syndrome by G-CSF use. ANCA was positive after using PTU in all three cases, suggesting a pathogenic role of PTU-induced ANCA in Sweet's syndrome.…”

“…1,3) Sweet's syndrome can also occur in patients with Hashimoto's thyroiditis, [4][5][6] and rarely in patients with Graves' disease, in which all reported cases were caused by use of propylthiouracil (PTU). [7][8][9] Extracutaneous manifestations of Sweet's syndrome can present in the ocular mucosa and mouth, as well as in the bone, central nervous system, kidneys, intestines, liver, heart, lungs, muscles, and spleen. 1,8) Here we report a case of Sweet's syndrome associated with Graves' disease per se but not a drug use.…”

“…[7][8][9] Extracutaneous manifestations of Sweet's syndrome can present in the ocular mucosa and mouth, as well as in the bone, central nervous system, kidneys, intestines, liver, heart, lungs, muscles, and spleen. 1,8) Here we report a case of Sweet's syndrome associated with Graves' disease per se but not a drug use.…”