丙硫氧嘧啶诱发抗中性粒细胞胞质抗体相关性血管炎致弥漫性肺泡出血综合征  

Propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis with diffuse alveolar haemorrhage syndrome

作　　者：林辉煌[1] 曾奕明[1] 陈晓阳[1] 林玲[2] 

机构地区：[1]福建医科大学附属第二医院呼吸内科,泉州362000 [2]福建医科大学附属第二医院免疫内科,泉州362000

出　　处：《药物不良反应杂志》2015年第2期144-145,共2页Adverse Drug Reactions Journal

摘　　要：1例22岁女性患者因甲状腺功能亢进症服用丙硫氧嘧啶（50 mg，2次／d），6个月后出现咳嗽、咯血。胸部CT示双肺多发斑片状病变。支气管镜肺泡灌洗液检查显示灌洗液呈血性，诊断为弥漫性肺泡出血综合征。入院第9天，血清髓过氧化物酶-抗中性粒细胞胞质抗体检测呈阳性。考虑为丙硫氧嘧啶诱发的抗中性粒细胞胞质抗体相关性血管炎。以甲巯咪唑取代丙硫氧嘧啶，并应用甲泼尼龙。5d后，患者咯血停止；8d后，肺部病变明显改善。随访1年，患者未再出现咯血。A 22-year-old female patient with hyperthyroidism received propylthiouracil 50 mg twice daily. After 6 months,she presented cough,hemoptysis,a chest CT scan revealed multiple patchy opacities in both lungs. Bronchoalveolar lavage fluid showed bloody pulmonary alveolus. Diffuse alveolar hemorrhage syndrome was diagnosed. On hospital day 9,the biochemical studies indicated serological positive findings for myeloperoxidase-anti-neutrophil cytoplasmic antibody. Propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis was considered. Propylthiouracil was switched to methimazole, and methylprednisolone was given. After 5 days,the hemoptysis stopped. After 8 days,her lung lesions improved significantly. During one-year follow-up,she had no hemoptysis.

关 键 词：丙硫氧嘧啶 抗中性粒细胞胞浆抗体相关性血管炎 

分 类 号：R543[医药卫生—心血管疾病]