心包炎:甲巯咪唑诱导的抗中性粒细胞细胞质抗体相关血管炎的罕见发作

M. Jemel, H. Sayadi, I. Khochtali
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引用次数: 0

摘要

抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)是一组以坏死性炎症为特征的小血管血管炎,很少或没有与髓过氧化物酶(MPO)ANCA或蛋白酶3(PR3)ANCA相关的免疫沉积。它包括显微镜下多血管炎、肉芽肿伴多血管炎(Wegner's)、嗜酸性肉芽肿伴多发血管炎(Churg Strauss)和单器官AAV(例如肾局限性AAV)[1]。即使这种血管炎的病因仍不清楚,据报道,有几个因素与AAV有关,更多地考虑了药物相关的ANCA相关血管炎[2]。通常耐受性良好的抗甲状腺药物(ATD)可能会产生轻微副作用,但在极少数AAV病例中可能会出现严重且可能危及生命的并发症[3]。到目前为止,丙基硫氧嘧啶(PTU)比氨甲唑(CBZ)或其活性代谢产物甲硫唑(MMI)更有可能与AAV相关[4]。皮肤病变和肾脏受累是该领域报道的最常见的临床特征。在这里,我们提出了第一个病例报告,一名25岁的女性在使用MMI一年后出现AAV,最初表现为心包炎。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pericarditis: Uncommon Onset of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Induced by Methimazol
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of small vessel vasculitides characterized by necrotizing inflammation, with few or no immune deposits associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA. It includes microscopic polyangiitis, granulomatosis with polyangiitis (Wegner’s), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and single-organ AAV (for renal example, renal-limited AAV) [1]. Even the etiology of this vasculitis is still unclear several factors have been reported to be associated with AAV with more consideration of drug-associated ANCAassociated vasculitis [2]. Antithyroid drugs (ATDs) which are generally well tolerated can be associated with minor side effect, but serious and potentially life-threatening complications can occurred in very rare cases with such AAV [3]. To date Propylthiouracil (PTU) is more likely to be associated with AAV than Carbimazole (CBZ) or his active metabolite Methimazole (MMI) [4]. Skin lesions and kidney involvement are the most common clinical features reported in this field. Here we present the first case report of a 25-yr-old woman who developed AAV initially presenting with pericarditis after 1 year of MMI use.
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