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A Case of Propylthiouracil Induced Diffuse Pulmonary Hemorrhage  

Lee, Sung Yong (Department of Internal Medicine, College of Medicine, Korea University)
Jung, Jin Yong (Department of Internal Medicine, College of Medicine, Korea University)
Lee, Kyoung Ju (Department of Internal Medicine, College of Medicine, Korea University)
Lee, Seung Hyeun (Department of Internal Medicine, College of Medicine, Korea University)
Kim, Se Joong (Department of Internal Medicine, College of Medicine, Korea University)
Lee, Eun Joo (Department of Internal Medicine, College of Medicine, Korea University)
Hur, Gyu Young (Department of Internal Medicine, College of Medicine, Korea University)
Jung, Hae Chul (Department of Internal Medicine, College of Medicine, Korea University)
Lee, Sang Yeub (Department of Internal Medicine, College of Medicine, Korea University)
Kim, Je Hyeong (Department of Internal Medicine, College of Medicine, Korea University)
Shin, Chol (Department of Internal Medicine, College of Medicine, Korea University)
Shim, Jae Jeong (Department of Internal Medicine, College of Medicine, Korea University)
In, Kwang Ho (Department of Internal Medicine, College of Medicine, Korea University)
Kang, Kyung Ho (Department of Internal Medicine, College of Medicine, Korea University)
Yoo, Se Hwa (Department of Internal Medicine, College of Medicine, Korea University)
Publication Information
Tuberculosis and Respiratory Diseases / v.58, no.1, 2005 , pp. 78-82 More about this Journal
Abstract
Propylthiouracil(PUT) is a drug which used at Grave's disease. But PTU has recently been observed to associated with antineutrophil cytoplasmic antibody(ANCA)-positive vasculitis resulting in, infrequently, diffuse alveolar hemorrhage. We report the case of a patient who developed diffuse pulmonary hemorrhage after she had been taking PTU for two years. She had received a diagnosis of Grave's disease at two years ago. The serologic study was positive for ANCA with myeloperoxidase(MPO) specificity. Bronchoalveloar lavage(BAL) fluid analysis revealed hemosiderinladen macrophages. Such findings suggested propylthiouracil-induced dffuse pulmonary hemorrhage associated with antineutrophil cytoplasmic antibody. To our knowledge, this represents the first documentation in a case of PTU-induced diffuse pulmonary hemorrhage in Korea.
Keywords
Propylthiouracil; ANCA; Diffuse alveolar hemorrhage;
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1 Yamauchi K, Sata M, Machiya J, Osaka D, Wada T, Abe S, et al. Antineutrophil cytoplasmic antibody positive alveolar haemorrhage during propylthiouracil therapy for hyperthyroidism. Respirology 2003;8:532-5   DOI   ScienceOn
2 Merkel PA. Drugs associated with vasculitis. Curr Opin Rheumatol 1998;10:45-50   DOI   PUBMED   ScienceOn
3 Green RJ, Ruoss SJ, Kraft SA, Duncan SR, Berry GJ, Raffin TA. Pulmonary capillaritis and alveolar hemorrhage: update on diagnosis and management. Chest 1996;110:1305-16   DOI   ScienceOn
4 Kawachi Y, Nukaga H, Hoshino M, Iwata M, Otsuka F. ANCA-associated vasculitis and lupus-like syndrome caused by methimazole. Clin Exp Dermatol 1995;20:345-7   DOI   ScienceOn
5 Katayama K, Hata C, Kagawa K, Noda M, Nakamura K, Shimizu H, et al. Diffuse alveolar hemorrhage associated with myeloperoxidase-antineutrophil cytoplasmic antibody induced by propylthiouracil therapy. Respiration 2002;69:473
6 Lee E, Miki Y, Katsura H, Kariya K. Mechanism of inactivation of myeloperoxidase by propylthiouracil. Biochem Pharmacol 1990;39:1467-71   DOI   ScienceOn
7 Ohtsuka M, Yamashita Y, Doi M, Hasegawa S. Propylthiouracil-induced alveolar haemorrhage associated with antineutrophil cytoplasmic antibody. Eur Respir J 1997;10:1405-7
8 Berkman EM, Orlin JB, Wolfsdorf J. An anti-neutrophil antibody associated with a propylthiouracil-induced lupus-like syndrome. Transfusion 1983;23:135-8   DOI   ScienceOn
9 Rhee Y, Chung SS, Nam SY, Song YD, Lim SK, Kim KR, et al. A case of propylthiouracil induced anti-neutrophil cytoplasmic antibody (ANCA) positive vasculitis. J Korean Soc Endocrinol 1999;14:757-63
10 Harper L, Cockwell P, Savage CO. Case of propylthiouracil-induced ANCA associated small vessel vasculitis. Nephrol Dial Transplant 1998;13:455-8   DOI   ScienceOn
11 Gunton JE, Stiel J, Caterson RJ, McElduff A. Clinical case seminar: anti‐thyroid drugs and antineutrophil cytoplasmic antibody positive vasculitis. J Clin Endocrinol Metab 1999;84:13-6   DOI   ScienceOn
12 Jiang X, Khursigara G, Rubin RL. Transformation of lupus-inducing drugs to cytotoxic products by activated neutrophils. Science 1994;266:810-3   DOI   PUBMED
13 von Schmiedeberg S, Goebel C, Gleichmann E, Uetrecht J. Neutrophils and drug metabolism. Science 1995;268:585-6
14 Gunton JE, Stiel J, Clifton-Bligh P, Wilmshurst E, McElduff A. Prevalence of positive anti-neutrophil cytoplasmic antibody (ANCA) in patients receiving anti-thyroid medication. Eur J Endocrinol 2000;142:587
15 Dhillon SS, Singh D, Doe N, Qadri AM, Ricciardi S, Schwarz MI. Diffuse alveolar hemorrhage and pulmonary capillaritis due to propylthiouracil. Chest 1999;116:1485-8   DOI   ScienceOn