Document Detail


A long-term follow-up of serum myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) in patients with Graves disease treated with propylthiouracil.
MedLine Citation:
PMID:  19851036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Propylthiouracil (PTU) is known to induce myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) in patients with Graves disease (GD). Previously, we showed that serum MPO-ANCA were frequently seen in patients with GD treated with PTU. In this study, we analyzed 13 patients with positive MPO-ANCA examining a long-term clinical consequence of these patients as well as antibody titers during 5.6 +/- 3.0 years. PTU therapy was continued in 8 patients and discontinued in 5 patients. Antibody titers decreased in 7 of 8 patients who discontinued PTU therapy but remained positive in 5 patients 5 years after PTU withdrawal. The initial MPO-ANCA levels were significantly higher in those antibody titers remained positive for longer than 5 years (n=5) than in those titers turned to be negative within 5 years after PTU withdrawal (n=3) (203 +/- 256 EU and 22 +/- 2 EU, respectively, P=0.04), but there were no significant differences in age, gender, duration of PTU therapy or dosage of PTU. Among 5 patients who continued PTU therapy, 2 patients with initially low MPO-ANCA titers turned to having negative antibody. No patients had new symptoms or signs of vasculitis throughout the follow-up periods. The long-term follow-up study suggests that higher MPO-ANCA levels remain positive for years after PTU withdrawal but are rarely associated with vasculitis.
Authors:
Reiko Ishii; Misa Imaizumi; Akane Ide; Nobuko Sera; Ikuko Ueki; Ichiro Horie; Takao Ando; Toshiro Usa; Eri Ejima; Kiyoto Ashizawa; Katsumi Eguchi
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Publication Detail:
Type:  Journal Article     Date:  2009-10-23
Journal Detail:
Title:  Endocrine journal     Volume:  57     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2010  
Date Detail:
Created Date:  2010-01-29     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  73-9     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Metabolism, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibodies, Antineutrophil Cytoplasmic / blood*
Antithyroid Agents / adverse effects,  therapeutic use*
Female
Follow-Up Studies
Graves Disease / blood,  drug therapy*,  enzymology,  immunology*
Humans
Male
Middle Aged
Peroxidase / antagonists & inhibitors,  immunology*
Propylthiouracil / adverse effects,  therapeutic use*
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Antithyroid Agents; 51-52-5/Propylthiouracil; EC 1.11.1.7/Peroxidase

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