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Benzylthiouracil-induced ANCA-associated Vasculitis: A Case Report and Literature Review
- Source :
- European Journal of Case Reports in Internal Medicine (2019), European Journal of Case Reports in Internal Medicine
- Publication Year :
- 2019
- Publisher :
- SMC MEDIA SRL, 2019.
-
Abstract
- Iatrogenic antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is not exceptional. Many cases of small vessel vasculitis induced by anti-thyroid drugs (ATD), mainly propylthiouracil (PTU), have been reported. We present a case of AAV related to another ATD: benzylthiouracil (BTU) and review the literature. An 84-year-old man with a 4-year history of multinodular goitre with hyperthyroidism was treated with BTU. He presented an acute syndrome with weakness, fever, epigastric pain and abdominal distension. Lactate and lipase tests were normal. An abdominal scan showed a thrombosis of the splenic artery with splenic infarction. We excluded a hypothesis of associated embolic aetiology: atrial fibrillation, atrial myxoma, intraventricular thrombus or artery aneurysm. Exploration of a possible prothrombotic state (complete blood count, haemostasis tests, activated protein C resistance, factor V Leiden, protein C, S, antithrombin III) gave normal results. Tests for antinuclear antibodies (ANA) and antiphospholipid antibodies (APL) were negative. However, testing for p-ANCA, with antimyeloperoxidase (MPO) specificity, was positive: 120.6 CU (N
- Subjects :
- medicine.medical_specialty
Anti-nuclear antibody
business.industry
lcsh:R
Autoantibody
anca vasculitis
lcsh:Medicine
Articles
benzylthiouracil
medicine.disease
Thrombosis
Gastroenterology
Benzylthiouracil
Internal medicine
Splenic infarction
Internal Medicine
medicine
hyperthyroidism
Propylthiouracil
cardiovascular diseases
Activated protein C resistance
Vasculitis
business
medicine.drug
anti-thyroid drugs
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- European Journal of Case Reports in Internal Medicine (2019), European Journal of Case Reports in Internal Medicine
- Accession number :
- edsair.doi.dedup.....961d097477178205d2b8109fc750724d