Your browser does not support the NLM PubReader view.

Go to this page to see a list of supporting browsers.
The Ewha Medical Journal
Ewha Womans University School of Medicine

Ewha Med J 2010; 33(2):109-113

pISSN: 1598-7450

DOI: https://doi.org/10.12771/emj.2010.33.2.109

Case Report

Propylthiouracil-Induced ANCA-Positive Diffuse Alveolar Hemorrhage in a Patient with Thyroid Storm

Soo Hyun Kim, Eun Mi Song, Doo Hyun Beak, Hyun Jung Oh, Hyun Kyung Kim, Min Young Choi, Kyung Joo Kwon, Hye Won Kang, Seo Woo Kim, Unjin Shim, Yeon Ah Sung, Young Sun Hong
Corresponding author (imhys@ewha.ac.kr)

Copyright ⓒ 2010. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Sep 30, 2010

Abstract

Propylthiouracil(PTU) is a commonly used antithyroid drug in the management of hyperthyroidism. However, it is associated with a variety of side effects. Antineutrophil cytoplasmic antibody( ANCA)-positive vasculitis is an extremely rare side effect of PTU. We report a case of a patient with diffuse pulmonary hemorrhage while being treated with PTU. A 28-year-old woman was admitted due to fever and abdominal pain. She was diagnosed as Graves' disease 4 years before the admission, and was taking PTU intermittently. Thyroid storm was suspected and we treated her with PTU, hydrocortisone, lugol solution and propranolol. However, coughing was aggravated, with chest X-ray and computed tomography revealing diffuse alveolar hemorrhage. Perinuclear-ANCA was positive. After discontinuation of PTU, all symptoms resolved. In conclusion, ANCA-positive diffuse alveolar hemorrhage is a rare but a potential side-effect of PTU. Therefore, early awareness of this complication is important.

Keywords: Antineutrophil cytoplasmic antibody; Propylthiouracil; Thyroid storm; Diffuse alveolar hemorrhage