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Propylthiouracil-induced lupus, antiphospholipid syndrome, and stroke in a patient with graves hyperthyroidism.
MedLine Citation:
PMID:  22159057     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To describe a case of propylthiouracil-induced lupus, complicated with antiphospholipid syndrome and acute ischemic stroke.
DESIGN: Case report.
SETTING: Academic medical center. Patient  A 27-year-old man with a diagnosis of Graves disease developed multiple ischemic strokes 2 weeks after starting treatment with propylthiouracil. Thyrotoxicosis and abnormal hypercoagulable and rheumatological profiles were remarkable, with prolonged partial thromboplastin time, elevated anticardiolipin antibody level, and positive antinuclear antibody, lupus anticoagulant, Sjögren antibody, and anti-double-stranded DNA antibody test results, which were more than 8-fold greater than normal values. No clinical manifestations of systemic lupus erythematosus were present. Intervention  Discontinuation of propylthiouracil and treatment with radioactive iodine.
RESULTS: Hyperthyroidism resolved and anti-double-stranded DNA antibodies returned to normal levels. Eventually, antiphospholipid syndrome was diagnosed. He was treated with oral anticoagulation and remained asymptomatic for 1 year of follow-up.
CONCLUSION: In this young man with Graves hyperthyroidism, treatment with propylthiouracil was associated with transient autoimmune reactions suggestive of drug-induced lupus, antiphospholipid syndrome, and acute ischemic stroke.
Authors:
Gustavo A Ortiz; Violet Lagari-Libhaber; Luz Marina Prieto-Sanchez; Alejandro A Rabinstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  68     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1587-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. rabinstein.alejandro@mayo.edu.
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