Clinical characteristics of myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis caused by antithyroid drugs.

Abstract

CONTEXT:

The clinical characteristics of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis caused by antithyroid drugs are still unclear because most reports describe only a small number of patients.

OBJECTIVE:

The objective was to analyze a large number of patients with MPO-ANCA-associated vasculitis to determine the time of onset, the drug and dose taken, the clinical symptoms, the relationship between the clinical symptoms and the MPO-ANCA titer, and the incidence.

DESIGN:

We analyzed 92 patients in whom the adverse reaction of MPO-ANCA-associated vasculitis was reported to Chugai Pharmaceutical, a company that markets antithyroid drugs.

RESULTS:

Of the 92 patients, 41 (44.6%) had single-organ failure, 32 (34.8%) had two-organ failure, 13 (14.1%), had three-organ failure, and two (2.2%) had four-organ failure. The number of organs involved was unknown in the other four patients (4.3%). The median time of onset was 42 months (range, 1-372 months) after starting drug treatment. The median dose at onset of MPO-ANCA-associated vasculitis was 15 mg/d (range, 2.5-45 mg/d) for methimazole and 200 mg/d (50-450 mg/d) for propylthiouracil. The severity and number of organs involved were not correlated with the MPO-ANCA titer. The incidence was between 0.53 and 0.79 patients per 10,000, and the ratio of the estimated incidences for methimazole and propylthiouracil was 1:39.2.

CONCLUSIONS:

The time of onset of MPO-ANCA-associated vasculitis and the dose at onset varied. The severity and number of organs involved were not correlated with the MPO-ANCA titer, indicating a need for vigilance even when the MPO-ANCA titer is only weakly positive.

• Authors: Jaeduk Yoshimura Noh, Shigemitu Yasuda, Shotaro Sato, Masako Matsumoto, Yo Kunii, Yoshihiko Noguchi, Koji Mukasa, Kunihiko Ito, Koichi Ito, Osamu Sugiyama, Hiroshi Kobayashi, Shigeru Nihojima, Masaru Okazaki, Shunji Yokoyama
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 94 Issue 8 Pg. 2806-11 (Aug 2009) ISSN: 1945-7197 [Electronic] United States
• PMID: 19491223 (Publication Type: Journal Article)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic
• Antithyroid Agents
• Peroxidase

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Antineutrophil Cytoplasmic (blood, physiology)
• Antithyroid Agents (adverse effects)
• Child
• Female
• Humans
• Male
• Middle Aged
• Peroxidase (immunology)
• Vasculitis (etiology)