Inactivation of peroxidases of rat bone marrow by repeated administration of propylthiouracil is accompanied by a change in the heme structure

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

“…There may be a specific reason why the anti-thyroid drug itself, especially PTU, can induce MPO-ANCA and ANCA-associated vasculitis. It was previously reported that PTU accumulates in neutrophils and binds to MPO [26,27]. Lee et al [27] reported that repeated administration of PTU altered the MPO structure surrounding the heme iron.…”

“…It was previously reported that PTU accumulates in neutrophils and binds to MPO [26,27]. Lee et al [27] reported that repeated administration of PTU altered the MPO structure surrounding the heme iron. It is suggested that changing the configuration of MPO may induce the antigenicity.…”

Thionamides-Related Vasculitis in Autoimmune Thyroid Disorders: Review of Current Literature and Case Reports

“…Although the pathogenetic role of these autoantibodies in drug-induced vasculitis has not been fully elucidated yet, several hypotheses have been proposed. Thus, it has been reported that PTU can selectively accumulate into neutrophils where it can bind to myeloperoxidase, changing or inactivating the heme structure of the enzyme (Lee et al, 1988). It has been suggested that, in susceptible individuals, the enzyme altered by PTU could then stimulate the production of anti-myeloperoxidase antibodies, inducing neutrophils degranulation and vascular damage (D'Cruz et al, 1995).…”

A Long-term Follow-up of Serum Myeloperoxidase Antineutrophil Cytoplasmic Antibodies (MPO-ANCA) in Patients with Graves Disease Treated with Propylthiouracil

“…it is suggested that patients known to have low levels of MPo-anca should be under a close observation in order to find early clinical signs and symptoms relating vasculitis in addition to measure MPo-anca periodically when rather than GD itself might be closely associated with MPo-anca. although the precise mechanism(s) how MPo-anca develops remain unclear, PTU has been shown to accumulate in the neutrophils [16] and to bind the MPo antigen with altering its structure [17]. it has been, therefore, suggested that the structural change of MPo antigen induced might promote development of anca in susceptible individuals [18].…”