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KMID : 0882420110810030397
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Korean Journal of Medicine
2011 Volume.81 No. 3 p.397 ~ p.402
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A Case of MPO-ANCA Positive Vasculitis Associated with Pulmonary Nodules and Membranous Nephropathy Following Propylthiouracil Treatment
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Ryu Kwang-Duck
Bae Min-Jung
Baek Dong-Hoon
Shin Min-Ji
Seong Eun-Young
Song Sang-Heon
Kwak Ihm-Soo
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Abstract
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Vasculitis is one of the rare complications of antithyroid drugs. In most cases, it is associated with ANCA and usually involves more than one organ. Renal involvement is the most common manifestation, and mainly presents as pauci-immune glomerulonephritis. We experienced MPO-ANCA-positive vasculitis and renal involvement presenting as membranous nephropathy following propylthiouracil (PTU) treatment. Cases of MPO-ANCA-positive vasculitis with membranous nephropathy are very uncommon, and the relationship between PTU and glomerulonephritis with immune complex deposition is unclear at present. A 58-year-old woman who had been treated with PTU for Graves’ disease was admitted because of dyspnea and general edema. Chest computed tomography showed multiple nodules in both lung fields. The serum level of MPO-ANCA was positive. Initial laboratory findings included proteinuria, hematuria and increased serum creatinine. We thought that MPO-ANCA-associated vasculitis was induced by PTU and renal involvement. Renal biopsy revealed membranous nephropathy.
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KEYWORD
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Propylthiouracil, ANCA-associated vasculitis, Pulmonary nodule, Membranous nephropathy
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