甲巯咪唑致抗中性粒细胞胞质抗体相关性血管炎1例并文献复习  

Methimazole-induced anti-neutrophil cytoplasmic antibody associated vasculitis: a case report and literature review

作　　者：倪海薇 古再丽努尔·赛来阿吉木 张菁菁[1] 刘珍[1] 陆晨 Ni Haiwei;Guzailinuer-Sailaiajimu;Zhang Jingjing;Liu Zhen;Lu Chen(Nephrology Center of First Affiliated Hospital of Xinjiang Medical University,Xinjiang Branch of National Clinical Research Center for Kidney Disease,Institute of Nephrology of Xinjiang,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院肾脏疾病中心国家肾脏疾病临床医学研究中心新疆分中心新疆维吾尔自治区肾脏病研究所,乌鲁木齐830011

出　　处：《中华肾脏病杂志》2025年第2期128-133,共6页Chinese Journal of Nephrology

基　　金：新疆维吾尔自治区重大科技专项项目(2022A03001-2);新疆维吾尔自治区区域协同创新专项(上海合作组织科技伙伴计划及国际科技合作计划)项目(2023E01020);新疆肾脏替代治疗(慢性肾脏病)临床医学研究中心建设项目;天山英才-高层次领军人才项目(2022TSYCLJ0022);新疆医科大学重大科研项目培育项目(XYD2024ZX05)。

摘　　要：关于抗甲状腺药物导致的抗中性粒细胞胞质抗体相关性血管炎(anti-neutrophil cytoplasmic antibody associated vasculitis,AAV)时有报道,但甲巯咪唑导致的AAV较为罕见。本文报道了1例54岁男性患者,该患者在服用甲巯咪唑20余天后,出现AAV并合并多器官功能衰竭。在及时停止致病药物甲巯咪唑后,患者接受了甲泼尼龙冲击治疗、环磷酰胺免疫抑制治疗及肾脏替代治疗等措施,病情缓解且无复发。Anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV)induced by anti-thyroid drugs has been reported occasionally,but methimazole-induced AAV is not as frequently reported.This case report described a 54-year-old male who developed AAV and multiple organ failure after more than 20 days of methimazole treatment.After timely discontinuation of the disease-causing drug methimazole,the patient received methylprednisolone shock,cyclophosphamide immunosuppression,renal replacement therapy,and other supportive treatments,and the disease was alleviated without recurrence.

关 键 词：甲疏咪唑 抗中性粒细胞胞质抗体相关性血管炎 多器官功能衰竭 抗肾小球基膜疾病 急进性肾小球肾炎 月肺出血 

分 类 号：R593.2[医药卫生—内科学]