Abstract

Objective A report of 1 case of antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis complicated with acute kidney injury caused by taking propylthiouracil (PTU). Methods The medical history, laboratory serology and renal biopsy were collected. The diagnosis and treatment were analyzed. The literature of Propylthiouracil induced ANCA-associated vasculitis was reviewed. Results A 15-year-old female patients presenting with sudden oliguria and proteinuria onset developed renal failure and positive blood MPO-ANCA rapidly. Renal biopsy revealed: (1) glomerular segment necrotic lesions and crescents (5/7), considering ANCA-associated vasculitis (propylthiouracil related), (2) glomerular capillary hypertrophy lesions, immunofluorescence showed mass C3 deposition. In light of a history of hyperthyroidism treated with PTU for 3 years, of the patient was diagnosed as: 1. propylthiouracil (PTU) induced vasculitis; 2. acute kidney injury. After treatment with immediate PTU withdrawal, 4 cycles of continuous renal replacement therapy and 3 cycles of methylprednisolone, the child recovered renal function and normal urine output. Follow-up of at 4th month showed the indicators returned to normal. Conclusion PTU can lead to ANCA-positive vasculitis with acute kidney injury, early diagnosis and treatment can improve the prognosis. Key words: Propylthiouracil; Antineutrophil cytoplasmic antibodies; Vasculitis; Acute renal failure

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