丙基硫氧嘧啶致肺血管炎1例报告及讨论

Propylthiouracil Induced Pulmonary Vasculitis in 1 Patient

血管炎是丙基硫氧嘧啶的一种少见的药物不良反应,常累及皮肤和肾脏,肺部合并症罕见。本文报道的一例丙基硫氧嘧啶所致的抗中性粒细胞胞浆抗体(ANCA)阳性血管炎患者却仅有肺部受累表现,并在病程中出现呼吸衰竭。作者对其进行了纤维支气管镜及支气管透壁肺活检等检查。该例患者血中和支气管肺泡灌洗液中均检测到ANCA阳性,且非常见抗原类型,作者又对其抗原特异性进一步进行了分析。经停药并加用糖皮质激素治疗后,该患者症状完全消失。

Propylthiouracil (PTU) is known to cause vasculitis as a rare complication. The pulmonary complications are extremely rare. This paper reports the case of patient who developed diffused interstitial pneumonitis and respiratory failure without other systemic complications whilst treated with PTU. Flbrobronchoscopy and trans-bronchial lung biopsy was made. The serum and bronchoalveolar lavage fluid were all positive for antineutrophil cytoplasmic antibody (ANCA) without specificity to myeloperoxidase (MPO) and proteinase 3 (PR3). Its specificity was analyze to other 5 components of ANCA. All symptoms resolved completely after discontinuation of PTU and corticosteroid therapy.