| The onset of antineutrophil cytoplasmic antibody-associated vasculitis immediately after methimazole was switched to propylthiouracil in a woman with Graves' disease who wished to become pregnant. | |
| | |
MedLine Citation:
|
PMID: 23154533 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Propylthiouracil (PTU) is recommended as a first-line antithyroid drug (ATD) during first trimester organogenesis in pregnancy because recent evidence suggests that methimazole (MMI) may be associated with congenital anomalies. However, PTU more commonly causes myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, which usually occurs during prolonged treatment, compared with MMI. We report a case of MPO-ANCA-associated vasculitis in a 35-year-old woman with Graves' disease. Although her thyroid function could be maintained euthyroid by MMI, her ATD was switched to PTU because she wished to become pregnant. The patient presented with flu-like symptoms 8 days after starting PTU and developed hemoptysis and dyspnea at 22 days. Her MPO-ANCA titer was 21 ELISA units (EUs) before PTU treatment but increased to 259 EUs at 22 days after PTU treatment. Her clinical condition improved with the discontinuation of PTU and with immunosuppressive therapy. This case indicated that MPO-ANCA vasculitis occurred within several weeks after the initiation of PTU and that this side effect could be caused by the change from MMI to PTU. Thus, our clinical observation suggests that patients treated with PTU should be carefully monitored for MPO-ANCA titers and variable manifestations of MPO-ANCA-associated vasculitis regardless of the period of administration. |
| | |
Authors:
|
Moritsugu Kimura; Toshiro Seki; Hideki Ozawa; Toru Ishihara; Masamichi Komatsu; Sakurako Tajiri; Hidetaka Yanagi; Makoto Nishina; Jaeduk Yoshimura Noh; Masafumi Fukagawa; Atsushi Takagi |
Related Documents
:
|
22872273 - Faciocraniosynostosis: monobloc frontofacial osteotomy replacing the two-stage strategy? 23212693 - Long-term self-reported treatment effects and experience of radiofrequency-induced ther... 12562483 - Efficacy and safety of caudal injection of levobupivacaine, 0.25%, in children under 2 ... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-11-16 |
Journal Detail:
|
Title: Endocrine journal Volume: - ISSN: 1348-4540 ISO Abbreviation: Endocr. J. Publication Date: 2012 Nov |
Date Detail:
|
Created Date: 2012-11-16 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9313485 Medline TA: Endocr J Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa 259-1193, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Long term effects of the implantation of Wharton's jelly-derived mesenchymal stem cells from the umb...
Next Document: A Single Divinyl Reductase Is Responsible for Reducing 8-Vinyl Groups of Various Intermediates of Ch...