Concomitant drug- and infection-induced antineutrophil cytoplasmic autoantibody [anca]-associated vasculitis with multispecific anca

ABSTRACT

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-mduced AAV