High Prevalence of Antineutrophil Cytoplasmic Antibody Positivity in Childhood Onset Graves’ Disease Treated with Propylthiouracil
Propylthiouracil (PTU)-induced antineutrophil cytoplasmic antibody (ANCA)-related vasculitis and nephritis were recently reported in about 30 patients with hyperthyroidism. The objective of this study was to clarify the prevalence of ANCA and the relationship between ANCA and thyroid antibodies in c...
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Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2000-11, Vol.85 (11), p.4270-4273 |
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Sprache: | eng |
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Zusammenfassung: | Propylthiouracil (PTU)-induced antineutrophil cytoplasmic antibody
(ANCA)-related vasculitis and nephritis were recently reported in about
30 patients with hyperthyroidism. The objective of this study was to
clarify the prevalence of ANCA and the relationship between ANCA and
thyroid antibodies in children with Graves’ disease.
Titers of myeloperoxidase (MPO)-ANCA in sera of 51 patients with
childhood onset Graves’ disease (16 before treatment, 25 and 10
treated with PTU and methimazole, respectively) were measured by
enzyme-linked immunosolvent assay. Antithyroglobulin antibodies (TGAbs)
and antithyroperoxidase antibodies (TPOAbs) were also measured by RIA
in 25 PTU-treated patients. No patients had clinical manifestations of
vasculitis and nephritis. MPO-ANCA was positive in 6.7% of patients
before treatment and in 64.0% of those treated with PTU and in none of
those treated with methimazole. MPO-ANCA had a significantly positive
correlation with TGAbs (P < 0.05) and no significant
correlation with TPOAbs.
These findings show the high prevalence of the MPO-ANCA positivity in
PTU-treated childhood onset Graves’ disease, suggesting that PTU may
not be preferred as the first line for the treatment of children with
Graves’ disease. The significant correlation between MPO-ANCA and
TGAbs indicates that the severity of Graves’ disease may be a factor
responsible for the MPO-ANCA positivity. The cross-reactivity between
MPO-ANCA and TPOAbs may not play a role in the high prevalence of
MPO-ANCA in the patients exposed to PTU. |
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ISSN: | 0021-972X 1945-7197 |
DOI: | 10.1210/jcem.85.11.7000 |