A case of prophylthiouracil associated ANCA positive acute glomerulonephritis / 대한내과학회지

ABSTRACT

Vasculitis is a rare complication of antithyroid drugs. Recently it was reported in association with ANCA. In most cases, the ANCA was specific for myeloperoxidase. The glomerulonephritis was key clinical manifestation in majority of cases. When antithyroid drugs were discontinued, clinical disease generally improved and ANCA titers were tended to fall. We experienced a 44 year old woman who presented with gross hematuria and generalized edema, after she had been treated with prophylthiouracil for 6 week for thyrotoxicosis. Renal biopsy was done, which showed mesangial proliferative glomerulonephritis. Indirect immunoflurorescence staining showed highly positive perinuclear pattern of ANCA in her serum. Prophylthiouracil associated ANCA positive glomerulonephritis was suspected. After cessation of prophylthiouracil and administration of prednisolone, renal function recovered gradually and ANCA titers were reduced. We hereby report a case of prophylthiouracil associated ANCA positive glomerulonephritis with a brief review of literature.