ABSTRACT
Vasculitis is a rare complication of propylthiouracil therapy. Antineutrophil cytoplasmic antibodies (ANCA) have been described in association with several vasculitic disorders. We report detection of ANCA against human neutrophil elastase, proteinase 3, and myeloperoxidase in serum from six patients who developed evidence of vasculitis during propylthiouracil treatment of hyperthyroidism. On withdrawal of the drug ANCA concentrations fell and clinical symptoms resolved completely.
Subject(s)
Autoantibodies/immunology , Immunoglobulin G/immunology , Propylthiouracil/adverse effects , Vasculitis/chemically induced , Adult , Aged , Antibodies, Antineutrophil Cytoplasmic , Biomarkers , Female , Humans , Hyperthyroidism/drug therapy , Middle Aged , Propylthiouracil/therapeutic use , Vasculitis/immunologyABSTRACT
Pulmonary embolism (PE) is an important cause of morbidity and mortality in the Western World. Systemic heparinization is usually applied as the treatment of first choice. However, a subgroup of patients presenting with massive PE and haemodynamic deterioration die in the acute phase or remain severely disabled. Several studies have demonstrated the beneficial effects of thrombolytic agents in the treatment of massive PE. This communication presents two patients with clinically massive PE of recent onset (confirmed by lung perfusion scans) who were successfully treated with a single i.v. dose of 30 mg of anisoylated lys-plasminogen streptokinase activator complex (APSAC, comparable to 1,500,000 U of streptokinase) followed by systemic heparinization for 7 days. Both patients showed a considerable improvement in their clinical condition shortly after APSAC administration. Control perfusion scans made after two days revealed marked reduction of perfusion defects.
