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Anti neutrophil cytoplasmic antibody associated vasculitis: 5 case reports In a study, five women aged 21–63 years were described, who developed anti-neutrophil cytoplasmic antibody (ANCA)associated vasculitis during treatment with anti-thyroid drugs (ATD) propylthiouracil or thiamazole for Graves’ disease [not all routes stated; duration of treatments to reactions onset not stated]. The patients, who had Graves’ disease, presented to hospital with various symptoms affecting skin, lungs, kidneys, blood or joints. The patients had been receiving ATD therapy with propylthiouracil 150–300mg daily (3 patients), thiamazole [methimazole] 20mg daily (1 patient) and oral propylthiouracil 100mg two times a day (1 patient). The patients were hospitalised for further interventions. Perinuclear ANCA was positive in 3 patients, protease 3 antibody was positive in 2 patients, cytoplasmic ANCA was positive in 2 patients and myeloperoxidase antibody was positive in 1 patient. Laboratory investigations led to a diagnosis of ANCAassociated vasculitis secondary to propylthiouracil (4 patients) and thiamazole (1 patient). On additional laboratory and diagnostic findings, one of the five patients was diagnosed with moderate anaemia, hypoproteinaemia, haematuria, proteinuria, gastrointestinal haemorrhage, secondary pulmonary disease, secondary renal lesions, lung infection and acute tonsillitis, which were considered as complications of ANCA-associated vasculitis. Therefore, ATD therapy was discontinued immediately in all the patients. Duration of ATD therapy was 3–6 months (2 patients) and 35–60 months intermittently (3 patients). Additionally, two of the five patients were treated with methylprednisolone sodium succinate, cyclophosphamide, hydroxychloroquine or methotrexate. Eventually, all the patients’ clinical symptoms resolved. Jiang W, et al. Fives cases of anti-neutrophil cytoplasmic antibody-associated vasculitis induced by anti-thyroid drugs and literature analysis. Pharmaceutical Care and Research 20: 37-40, No. 1, Feb 2020. Available from: URL: http://www.cqvip.com/qk/84056x/202001/7100933564.html [Chinese; summarised from a translation] 803520009

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Reactions 12 Dec 2020 No. 1834