Propylthiouracil Associated Antineutrophil Cytoplasmic Antibodies (ANCA) in Patients with Childhood Onset Graves' Disease
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Abstract
Propylthiouracil (PTU) can induce anti-myeloperoxidase (MPO-ANCA) positive vasculitis. We performed a cross-sectional study to estimate the prevalence of MPO-ANCA in patients with childhood onset Graves' disease (GD) receiving PTU and to assess the relationship between ANCA and clinical manifestations of vasculitis. We studied 60 patients (59 girls and one boy) between 7.3 and 25.0 years of age (mean ± SD, 14.71 ± 4.49). GD, diagnosed at the age of 3.0 to 14.5 years (11.3 ± 2.48), was designated as: newly diagnosed, on PTU therapy, and after PTU discontinuation in 4, 50 and 6 patients, respectively. Manifestations of vasculitis were noted and the patients were tested for MPOANCA, antinuclear antibodies, blood urea nitrogen, creatinine and urine analysis. Twentysix patients (43.3%) reacted positively for MPOANCA, 23 were on PTU therapy (0.42 to 6.00, median 3.00 years) and three had discontinued PTU. There were 34 (56.7%) ANCA-negative patients and 27 patients on PTU therapy (0.25 to 5.17, median 1.00 years, p = 0.012). Vasculitis presented in 16 patients (26.7%), all of whom were receiving PTU at the time of the study. The percentage of vasculitis among MPO-ANCA positive patients was 27.6% more than in the negative group, p = 0.017. PTU was discontinued in patients with vasculitis and positive for MPO-ANCA. Our findings show a high prevalence of MPO-ANCA positivity and a significantly higher percentage of vasculitis among these patients, suggesting that patients taking PTU should be closely observed for the appearance of MPOANCA and signs of vasculitis, especially patients GD who have been treated for a long time.
© 2020 by Walter de Gruyter Berlin/Boston
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Articles in the same Issue
- TITLE
- TABLE OF CONTENTS
- EDITORIAL. Why the Consensus for Consensus?
- REVIEW. Translating Transition: A Critical Review of the Diabetes Literature
- SOCIETY NEWS. VanWyk Award Acceptance Speech, May 5, 2008
- IMAGES IN PEDIATRIC ENDOCRINOLOGY. Pseudopuberty and Juvenile Hypothyroidism
- ORIGINAL CONTRIBUTIONS
- Long-term Follow-up of Patients with Congenital Hyperinsulinism in Austria
- An Analysis of Predictive Factors for the Conversion from Premature Thelarche into Complete Central Precocious Puberty
- Propylthiouracil Associated Antineutrophil Cytoplasmic Antibodies (ANCA) in Patients with Childhood Onset Graves' Disease
- Molecular Analysis of the AR and SRD5A2 Genes in Patients with 46,XY Disorders of Sex Development
- Efficacy and Safety of Inhaled Human Insulin (Exu hera®) Compared to Subcutaneous Insulin in Children Ages 6 to 11 Years with Type 1 Diabetes Mellitus: Results of a 3-Month, Randomized, Parallel Trial
- Usefulness of Growth Hormone (GH) Stimulation Tests and IGF-1 Concentration Measurement in GH Deficiency Diagnosis
- Hyperglycemia and Hypoinsulinemia in Patients with Fanconi-Bickel Syndrome
- PATIENT REPORT LETTERS
- Glycogen Storage Disease Type Ilia Presenting as Non-Ketotic Hypoglycemia: Use of a Newly Approved Commercially Available Mutation Analysis to Non-Invasively Confirm the Diagnosis
- Clinical and Laboratory Findings of Two Newborns with Wiedemann-Rautenstrauch Syndrome: Additional Features, Evaluation of Bone Turnover and Review of the Literature
- Congenital Nephrotic Syndrome and Persistent Hypothyroidism After Bilateral Nephrectomy
- LETTER TO THE EDITOR
- Re: Relationship between endothelial dysfunction, carotid artery intima media thickness and circulating markers of vascular inflammation in obese hypertensive children and adolescents (J Pediatr Endocrinol Metab 2007; 20: 1125-1136)
- The Incidence of Glucose Disorders Related to Cystic Fibrosis Could Be Higher with Current Criteria (Re: Carbohydrate Metabolism Changes in Cystic Fibrosis. J Pediatr Endocrinol Metab 2007; 20: 621-663)
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