ArticleFrontiers in medicine2025
Propylthiouracil-induced ANCA-associated vasculitis complicated by granulocytopenia and hemophagocytosis: a case report.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Current landscape of drug induced retinal vasculitis.Journal of ophthalmic inflammation and infection · 2026Review
- Article
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6 authors.
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Abstract
Objective: To analyze a rare case of ANCA-associated vasculitis (AAV) complicated by hemophagocytosis and granulocytopenia induced by long-term propylthiouracil (PTU) therapy, providing insights for clinical diagnosis and management. Methods: A retrospective analysis was conducted on the clinical data and treatment course of a patient who developed AAV with hemophagocytosis and granulocytopenia after prolonged PTU use. Results: Upon admission, granulocytopenia secondary to PTU was suspected. Despite transient recovery of leukocyte counts with anti-infective therapy and granulocyte colony-stimulating factor (G-CSF), recurrent leukopenia and intermittent fever persisted. Bone marrow aspiration revealed hemophagocytic cells, while serologic testing showed positivity for both PR3-ANCA and MPO-ANCA. A definitive diagnosis of PTU-induced AAV was established. Glucocorticoid therapy normalized body temperature and restored leukocyte levels. Follow-up demonstrated resolution of thyrotoxicosis, stabilized leukocyte counts, and afebrile status. Conclusion: Long-term PTU therapy may trigger AAV accompanied by hemophagocytosis. Clinicians should consider screening for hemophagocytic lymphohistiocytosis (HLH) in such cases to guide timely immunosuppressive intervention.
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