2006
DOI: 10.1001/archderm.142.7.879
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Antineutrophil Cytoplasmic Antibody–Positive Cutaneous Leukocytoclastic Vasculitis Associated With Propylthiouracil Therapy

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Cited by 11 publications
(6 citation statements)
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References 5 publications
(7 reference statements)
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“…The major adverse effects of the two drugs broadly used in hyperthyroidism, PTU and MMI, are rash, urticaria, joint pain, stomach intolerance, agranulocytosis disease and liver toxicity (15). Furthermore, PTU can lead to production of cytoplasmic antibodies and vasculitis (12,16). With regard to hematological disorders, PTU is known to cause bone marrow aplasia and AML (17,18).…”
Section: Discussionmentioning
confidence: 99%
“…The major adverse effects of the two drugs broadly used in hyperthyroidism, PTU and MMI, are rash, urticaria, joint pain, stomach intolerance, agranulocytosis disease and liver toxicity (15). Furthermore, PTU can lead to production of cytoplasmic antibodies and vasculitis (12,16). With regard to hematological disorders, PTU is known to cause bone marrow aplasia and AML (17,18).…”
Section: Discussionmentioning
confidence: 99%
“…A relação causal entre as manifestações clínicas e o uso do PTU é sugerida pela melhora do quadro logo após a retirada da droga (1)(2)(3) . Além disso, o acometimento do lobo da orelha é freqüentemente descrito em séries de casos de vasculites relacionadas ao PTU, e essa característica pode ajudar na suspeita dessa associação (4)(5)(6) . O ANCA é um importante marcador sorológico de vasculites sistêmicas como a granulomatose de Wegener, síndrome de Churg-Strauss e poliangiíte microscópica (7) .…”
Section: Discussionunclassified
“…A partir daí, ocorreria a ativação de outros neutrófilos, provocando a liberação de enzimas e produção de radicais livres e citocinas, resultando em dano vascular (1,15) . A retirada da medicação é a principal medida recomendada para os pacientes que desenvolvem vasculite cutânea com ANCA positivo, induzida pelo PTU, pois freqüente-mente leva à resolução completa do quadro (1,2,4) . O uso de corticóides e imunossupressores só é necessário em casos graves, quando há envolvimento de órgãos nobres, como os acometimentos renal ou pulmonar (2,8) .…”
Section: Discussionunclassified
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“…However, it has been suggested that PTU selectively accumulates in the neutrophils and binds to myeloperoxidase (MPO), resulting in a change of the heme structure of the enzyme. The altered enzymes, possibly combined with the drug, might act as haptens and initiate production of anti-MPO autoantibodies, which then stimulate other neutrophils 10 . Activated primed neutrophils degranulate and produce oxygen free radicals, increasing the expression of adhesion molecules on both neutrophils and endothelial cells, stimulating the release of interleukin 8 and interfering with control of the enzyme activity of these target antigens 3,5,10 .…”
Section: Discussionmentioning
confidence: 99%