丙基硫氧嘧啶致儿童继发性抗中性粒细胞胞质抗体相关性小血管炎1例

Propylthioouracil-associated antineutrophil cytoplasmic antibody-positive vasculitis:1 case report and review of literature

目的分析丙基硫氧嘧啶(PTU)致抗中性粒细胞质抗体(ANCA)相关性小血管炎的机制。方法采用1例长期服用PTU患儿所致ANCA相关性小血管炎的临床资料。结果患儿因贫血、蛋白尿、肾功能不全,伴有咯血而就诊,追问病史发现其发病前曾服用PTU 3年,经免疫抑制、血浆置换等治疗后症状缓解,肾功能改善。结论 PTU可引起ANCA相关性小血管炎,及时停用相关药物以及应用免疫抑制剂、血浆置换等治疗,可使病情缓解。

Objective To analyze pathogenesis of antineutrophil cytoplasmic antibody-positive vasculitis induced by propylthiouracil (PTU).Method By reporting a case of Antineutrophil Cytoplasmic Antibody-positive Vasculitis induced by PTU.ResultsThe patient (who had been treated with PTU for 3 years because of hyperthyreosis) presented with hypohemia, proteinuria, renal function damage, injury of lungs, positive Antineutrophil Cytoplasmic Antibody.After immunosuppressive therapy, plasma exchange and other treatment, the symptoms of the patients were relieved and the renal function was restored.Conclusions PTU may induce Antineutrophil Cytoplasmic Antibody-positive Vasculitis. Early diagnosis, withdraw of ptu, plasma exchange and administration of glucocortocoid can improve its prognosis.