Propylthiouracil-associated antineutrophil cytoplasmic antibody positive crescentic glomerulonephritis

Abstract

The vasculitic syndromes of Wegeners granulomatosis, microscopic polyangitis, Churg-Strauss syndrome and renal limited variants are associated with antineutrophil cytoplasmic antibodies (ANCA). Positive ANCA are also seen in many viral infections, inflammatory bowel diseases and drugs. Drug-induced ANCA-associated renal disease is reported less frequently than drug-induced lupus nephritis. ANCA-positive crescentic glomerulonephritis due to propylthiouracil has been reported in children and adults especially in Japanese population. The renal outcome is better in propylthiouracil-associated ANCA-positive crescentic GN as compared with nondrug-induced crescentic GN. Propylthiouracil-associated ANCA-positive crescentic GN may or may not require steroid and cytotoxic therapy depending on the severity of renal failure. We report a case of propylthiouracil-associated ANCA-positive crescentic GN with severe renal failure; the renal function improved after steroid and cytotoxic therapy.