Propylthiouracil induced p-ANCA pyoderma gangrenosum: Case report and review of literature

Abstract

Propylthiouracil is a drug commonly used in patients with hyperthyroidism. Some patients with Graves using this drug may have a positive perinuclear antineutrophil cytoplasmic antibody (p-ANCA) associated with different forms of vasculitis and neutrophilic dermatoses. However, skin lesions such as maculopapular purpura, erythema, sensitive nodules, ulceration, vesiculobullous lesions, and livedo can be induced by antineutrophil cytoplasmic antibody (ANCA) -positive vasculitis. In these cases, the development of pyoderma gangrenosum (PG) is very rare. We aimed to present a concurrent development of pyoderma gangrenosum, p-ANCA positivity and inraalveolar hemorrhage in a patient who had been using PTU for a long time and to discuss the current literature with this presentation. We think that the baseline ANCA levels should be measured in all graves patients because of severe ANCA-related vasculitis in some patients during PTU therapy