Clinical characteristics and outcomes of propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis in patients with Graves' disease: A median 38-month retrospective cohort study from a single institution in China.

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Clinical characteristics and outcomes of propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis in patients with Graves' disease: A median 38-month retrospective cohort study from a single institution in China.

Thyroid. 2017 Oct 31;:

Authors: Yang J, Yao LP, Dong M, Xu Q, Zhang J, Weng WW, Chen F

Abstract
BACKGROUND: This study sought to investigate the clinical characteristics and outcomes of propylthiouracil (PTU)-induced antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in patients with Graves' disease.
METHODS: Sixteen patients diagnosed with PTU-induced ANCA-associated vasculitis in our hospital from January 2010 to June 2017 were analyzed retrospectively.
RESULTS: All sixteen patients with PTU-induced ANCA-associated vasculitis were female. The mean age (± standard deviation) of the patients was 39.4 ± 15.3 years (range, 19-69), and the median time of onset was 36 months (range, 1-193) post-PTU initiation. The median dose at the onset of PTU-induced ANCA-associated vasculitis was 150 (range, 50-300) mg/d. All patients had a positive serum perinuclear staining pattern (p-ANCA) and antibodies directed against myeloperoxidase (anti-MPO). Six patients tested positive for both anti-MPO antibodies and antibodies directed against proteinase-3 (anti-PR3). Seven (43.8%) patients' diseases involved a single organ. The kidney was the organ most commonly affected, as 12 (75%) patients were found to have disease involving this organ. PTU was stopped in all patients, corticosteroids were administered to 2 patients, and immunosuppressive agents and corticosteroids were administered to 5 patients. Three patients were lost to follow-up; however, the remaining patients achieved remission after a median follow-up period of 38 months (range, 6-76). Patients who were positive for pANCA and displayed cytoplasmic staining (cANCA) showed negative findings at rates of approximately 53.8% (7/13) and 100% (6/6), respectively, following treatment.
CONCLUSIONS: PTU-induced ANCA-positive vasculitis occurs at varying times and follows various doses of PTU. The condition follows a milder course and has a better prognosis after PTU cessation.

PMID: 29088997 [PubMed - as supplied by publisher]

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