Antineutrophil Cytoplasmic Autoantibody-Positîve Crescentic Glomerulonephritis Associated with Thiamazole Therapy

Occurrence of antineutrophil cytoplasmic antibodies and associated vasculitis in patients with hyperthyroidism treated with antithyroid drugs: A long‐term followup study

“…Clinical signs were present in 2 of 6 ANCA-positive 110 Slot et al patients who had used PTU, in 2 patients using other antithyroid drugs, and in none of the patients who were not treated with antithyroid drugs. The presence of ANCA, and of ANCA-associated vasculitis, in patients using antithyroid drugs for treatment of hyperthyroidism have been recurrently reported (15)(16)(17)(18)(19)(20)(21)(22)(23)27). Reported prevalence of ANCA in patients treated with antithyroid drugs varies from 4% to 46%; prevalence of AAV is lower (0 -1.4%) (22,(27)(28)(29).…”

“…There are several case reports implicating hydralazine (11)(12)(13)(14) and propylthiouracil (PTU) (15)(16)(17)(18)(19) in the induction of AAV. Occasionally, other drugs are mentioned, including other antithyroid drugs, such as carbimazole (17) and methimazole (20,21).…”

“…ANCA in drug-induced AAV are most frequently directed against MPO (11-16,18 -22); however, cases in which patients were PR3-ANCA positive are also observed (12,15,18,20,22). ANCA in these patients may also be directed against human leukocyte elastase (HLE) or lactoferrin, and the presence of ANCA directed to 2 or more antigens may even be an indication of drug-induced dis-ease (15,23).…”

Anti-Thyroid Drug-Induced ANCA-Associated Vasculitis. A Case Report and Review of the Literature.

“…Concerning small vessel vasculitis in patients with Graves' disease including that induced by anti-thyroid drugs, immune-complex vasculitis [2] and cutaneous vasculitis [3] have been reported. Recently, ANCA-associated vasculitis has also been described based on pathological findings and the clinical course [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . However, there has not been any detailed discussion concerning drug dose and duration of anti-thyroid drug use, or titers of myeloperoxidase (MPO)-ANCA, anti-nuclear antibody (ANA) and anti-thyroid antibodies.…”

“…However, there has not been any detailed discussion concerning drug dose and duration of anti-thyroid drug use, or titers of myeloperoxidase (MPO)-ANCA, anti-nuclear antibody (ANA) and anti-thyroid antibodies. It is interesting that most cases were reported from Japan Japanese Red Cross-Nagasaki Atomic Bomb Hospital, 3-15, Morimachi, Nagasaki 852-8511, Japan [4][5][6][7][8][9][10][11], but it is not clear why anti-thyroid drug-induced Q~NCA-associated vasculitis mainly happens to Japanese.…”