Concomitant drug- and infection-induced antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis with multispecific ANCA.

Medical principles and practice : international journal of the Kuwait University, Health Science Centre Pub Date : 2012-01-01 Epub Date: 2012-04-25 DOI:10.1159/000337944

Milica Kontic, Sanja Radovanovic, Milos Nikolic, Branka Bonaci-Nikolic

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引用次数: 7

Abstract

Objective: To report the first case of concomitant drug- and infection-induced antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) in a patient treated with propylthiouracil (PTU) and suffering from tuberculosis.

Presentation and intervention: A 28-year-old woman with PTU-treated hyperthyroidism presented with fever, purpura, pulmonary cavitations and ANCA to myeloperoxidase, bactericidal/permeability-increasing protein (BPI), proteinase-3 and elastase. Skin histopathology confirmed vasculitis. However, sputum examination revealed Mycobacterium tuberculosis. Remission was achieved after PTU withdrawal and treatment with antituberculosis drugs.

Conclusion: Our case confirmed that BPI-ANCA are elevated in active tuberculosis. Multispecific ANCA were helpful for the diagnosis of concomitant PTU- and M. tuberculosis-induced AAV.

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伴随药物和感染诱导的抗中性粒细胞胞浆自身抗体(ANCA)相关血管炎伴多特异性ANCA。

目的:报道首例使用丙硫脲嘧啶(PTU)治疗肺结核患者并发药物和感染诱导的抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)的病例。临床表现和干预:28岁女性甲状腺机能亢进患者经ptu治疗后表现为发热、紫癜、肺空化和髓过氧化物酶、抗菌/通透性增加蛋白(BPI)、蛋白酶-3和弹性酶的ANCA。皮肤组织病理学证实血管炎。然而，痰检查显示结核分枝杆菌。PTU停药和抗结核药物治疗后缓解。结论:本病例证实活动性肺结核患者BPI-ANCA升高。多特异性ANCA有助于PTU-和结核分枝杆菌诱导的AAV合并的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Medical principles and practice : international journal of the Kuwait University, Health Science Centre

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