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Propylthiouracil-induced lupus-like syndrome developing in a Graves' patient with a sibling with systemic lupus erythematosus.

Abstract
A 13-year-old girl with Graves' disease, whose younger sister had systemic lupus erythematosus, developed polyarthralgia, fever, neutropenia, hypergammaglobulinemia, and microscopic hematuria after treatment with propylthiouracil (PTU) for 2 years. Myeloperoxidase-anti-neutrophil cytoplasmic antibodies were strongly positive. Anti-single- and anti-double-stranded DNA antibodies were positive, whereas LE cells and anti-Sm antibodies were negative. PTU was discontinued and all symptoms subsided gradually. Two years later, the microscopic hematuria had disappeared completely. Both patients had the identical HLA-DR alleles (HLA-DR9). These present two cases in siblings suggest that both sisters had lupus diathesis, and that the elder sister developed a PTU-induced lupus-like syndrome.
AuthorsAkemi Yamada, Kanji Sato, Mitsuhiko Hara, Akiko Tochimoto, Sachiko Takagi, Naomi Hizuka, Kazue Takano
JournalInternal medicine (Tokyo, Japan) (Intern Med) Vol. 41 Issue 12 Pg. 1204-8 (Dec 2002) ISSN: 0918-2918 [Print] Japan
PMID12521217 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Antineutrophil Cytoplasmic
  • Antibodies, Antinuclear
  • Antithyroid Agents
  • HLA-DR Antigens
  • HLA-DR Serological Subtypes
  • HLA-DR9 antigen
  • Propylthiouracil
Topics
  • Adolescent
  • Antibodies, Antineutrophil Cytoplasmic (blood)
  • Antibodies, Antinuclear (blood)
  • Antithyroid Agents (adverse effects)
  • Female
  • Genetic Predisposition to Disease
  • Graves Disease (complications, drug therapy)
  • HLA-DR Antigens (genetics)
  • HLA-DR Serological Subtypes
  • Humans
  • Lupus Erythematosus, Systemic (chemically induced, genetics, immunology)
  • Propylthiouracil (adverse effects)
  • Siblings

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