丙基硫氧嘧啶致抗中性粒细胞胞浆抗体阳性患者的临床特点被引量：1

下载PDF

导出

摘要目的:探讨丙基硫氧嘧啶(PTU)导致抗中性粒细胞胞浆抗体(ANCA)阳性病例的临床特点,以提高对PTU导致ANCA阳性血管炎(APV)的认识。方法:分析澄海区人民医院自2002年以来8例因应用PTU导致的ANCA阳性病例的临床资料。结果:①8例患者发病年龄16～42岁(平均29.4岁),服用PTU5～46个月(平均26.3个月);②5例进行了ANCA靶抗原谱的测定,除抗髓过氧化物酶(MPO)外,均同时存在识别其他抗原的抗体,包括:抗蛋白酶3(PR3)、抗人白细胞弹力蛋白酶(HLE)、抗杀菌/通透性增高蛋白(BPI)和抗乳铁蛋白(LF);③5例核周型ANCA(pANCA)高滴度阳性(≥11∶280)的病例临床确诊为APV,另外3例pANCA低滴度阳性(≤13∶20)的病例无明确血管炎表现;④8例患者被发现ANCA阳性后停用PTU,其中1例APV仅停用PTU后病情缓解,另外4例APV同时予糖皮质激素和免疫抑制剂后病情逐渐缓解。结论:PTU可引起ANCA阳性,而高滴度pANCA阳性提示APV,其病情与抗体滴度相关;及时停用PTU,根据病变程度确定治疗方案,对改善APV的预后意义重大。

作者林秋强陈韧谭源源廖旻王绵炯

机构地区汕头市澄海区人民医院内科

出处《中国医药导报》 CAS 2008年第19期180-181,共2页 China Medical Herald

关键词丙基硫氧嘧啶抗体抗中性白细胞胞质血管炎

分类号 R581 [医药卫生—内分泌]

引文网络
相关文献

参考文献2

1徐旭东,赵明辉,章友康,郭晓惠,王海燕.丙基硫氧嘧啶导致的抗中性粒细胞胞质抗体阳性小血管炎及其靶抗原研究[J].中华内科杂志,2002,41(6):404-407. 被引量：54
2[2]Noh JY,Asari T,Hamada N,et al.Frequency of appearance of myeloperoxides-anti-neutrophil cytoplasmic antibody (MPO-ANCA) in Grave's disease patients treatment with propylthiouracil and the relationship between MPO-ANCA and clinical manifestations[J].Clin Endocrinol (Oxf),2001,54:651-654.

二级参考文献7

1Zhao MH, Jones SJ, Lockwood CM. Bactericidal / permeability-increasing protein (BPI) is an important antigen for antineutrophil cytoplasmic autoantibodies (ANCA) in vasculitis. Clin Exp Immunol, 1995, 99: 49-56.
2Zhao MH, Lockwood CM. Azurocidin is a novel antigen for antineutrophil cytoplasmic autoantibodies (ANCA) in systemic vascutilis. Clin Exp Immunol, 1996 , 103: 397-402.
3Harper L, Cockwell P, Savage CO. Case of propylthiouracil-induced ANCA associated small vessel vasculitis. Nephrol Dial Transplant, 1998, 13: 455-458.
4Miller RM, Savige J, Nassis L, et al. Antineutrophil cytoplasmic antibody (ANCA)-positive cutaneous leucocytoclastic vasculitis associated with antithyroid therapy in Graves′ disease. Australas J Dermatil, 1998, 39: 96-99.
5Choi HK, Merkel PA, Walker AM, et al. Drug-associated antineutrophil cytoplasmic antibody-positive vasculitis: prevalence among patients with high titers of antimyeloperoxidase antibodies. Arthritis Rheum, 2000, 43: 405-413.
6Kitahara T, Hiromura K, Maezawa A, et al. Case of propylthiouracil-induced vasculitis associated with anti-neutrophil cytoplasmic antibody (ANCA); review of literature. Clin Nephrol, 1997, 47:336-340.
7赵明辉,章友康,王海燕.加强抗中性粒细胞胞浆抗体检测方法的规范化及合理应用[J].中华内科杂志,1998,37(3):149-150. 被引量：39