CARBIMAZOLE-INDUCED PULMONARY VASCULITIS: A RARE ADVERSE EVENT OF A RELATIVELY COMMON DRUG

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TYPE: Abstract Publication TOPIC: Diffuse Lung Disease PURPOSE: Anti-Hyperthyroid medications have a large number of adverse effects, the commonest being skin rashes, and some are rare like agranulocytosis. Vasculitis is unheard of as an adverse event, and ANCA positivity is rarely if ever associated with drugs such as carbimazole. METHODS: We report an 84 year old female patient with Grave’s disease who developed ANCA-associated vasculitis with pulmonary involvement while on carbimazole. A 3 months history of fatigue, anorexia, and weight loss was followed by an acute hospital admission due to intermittent fevers and dry cough. RESULTS: Following an extensive panel of investigations and despite adequate conventional therapies her symptoms failed to resolve. An autoimmune screen later revealed a positively elevated MPO antibody. A presumptive diagnosis of microscopic polyangiitis was then made. CONCLUSIONS: This case highlights the awareness of this rare clinical entity and adverse effect of a thyroid medication which may lead to fatal renal and pulmonary complications. CLINICAL IMPLICATIONS: Early diagnosis and withdrawal of the offending medication is critically important. DISCLOSURE: No significant relationships. KEYWORDS: Carbimazole, ANCA-Vasculitis, pneumonitis