甲巯咪唑致粒细胞缺乏合并ANCA阳性1例并文献复习  

Methimazole-induced antineutrophil cytoplasmic antibody-associated neutropenia:one case report and literature review

作　　者：伍璞[1] 刘纯[1] 

机构地区：[1]重庆医科大学附属第一医院内分泌科,重庆400016

出　　处：《中国医药科学》2012年第6期11-13,共3页China Medicine And Pharmacy

基　　金：重庆市医学科研计划项目(2009-2-319)

摘　　要：抗甲状腺药物是Graves’病的一线治疗药物,粒细胞缺乏是其少见但严重的副作用,发生机制仍不十分清楚,目前认为主要和免疫反应有关。PTU能诱导ANCA的产生及ANCA相关性血管炎的发生,部分患者合并出现粒细胞减少。虽然粒细胞减少症并未列入ANCA相关的疾病谱,近年越来越多文献报道支持ANCA参与粒细胞减少的发生。这里报道一个MMI治疗后出现ANCA阳性合并严重粒细胞减少不伴血管炎的病例,并对相关的文献进行复习。Antithyroid drugs are widely used to treat hyperthyroidism,but they tend to cause agranulocytosis,which canbe mortal.It suggests an immune mechanism play a great role in its pathogenesis but this idea has not been completelyestablished.PTU can cause the development of ANCA and ANCA-associate vasculitis. Although neutropenia is not typicallyincluded in the ANCA-associated diseases.Howerver,ANCA might be also associated with autoimmune neutropenia insome cases reported.We report a case of MMI induced-agranulocytosis with positive ANCA and relevant literature on theassociation between ATD,ANCA and neutropenia is reviewed.

关 键 词：抗甲状腺药物 粒细胞减少症 抗中性粒细胞胞浆抗体 甲巯咪唑 丙硫氧嘧啶 

分 类 号：R595.3[医药卫生—内科学]