Propylthiouracil induced ANCA-positive vasculitis in a patient with Graves’ disease; a case report

Abstract

Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is rare, but it can be triggered by chemicals, infections, and drugs. Patients who use anti-thyroid drugs are prone to involve with ANCA-associated vasculitis. Perinuclear ANCA (p-ANCA) is almost always positive in these patients. Patients have various presentations and symptoms such as (arthritis, edema) and this disorder usually resolves with discontinuation of the drug, however, some patients require high-dose steroids, immunosuppressive or plasmapheresis. A 38-year-old woman with a history of Graves’ disease was on long-term treatment with propylthiouracil (PTU), presented with severe bone pain, arthritis and edema in both feet. The patient’s manifestations were resolved with discontinuation of PTU, iodine therapy, and corticosteroid administration.