Propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis

Nat Rev Nephrol. 2012 Jun 5;8(8):476-83. doi: 10.1038/nrneph.2012.108.


Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) refers to a group of potentially life-threatening autoimmune diseases. A recent development in this field is the recognition that certain drugs can induce AAV. Among these agents, the drug most often implicated in causing disease is the commonly used antithyroid agent propylthiouracil (PTU). This Review provides an update on PTU-induced AAV. Clinical characteristics of PTU-induced AAV are similar to that of primary AAV, but usually have a milder course and better prognosis, provided early cessation of the disease-causing drug. PTU-induced ANCAs usually react to several components of myeloid granules, which is helpful in differentiating PTU-induced AAV from primary AAV. Early cessation of PTU is crucial in the treatment of PTU-induced AAV. The duration of immunosuppressive therapy might be shorter than in primary AAV, depending on the severity of organ damage, and maintenance therapy is not always necessary.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Antineutrophil Cytoplasmic / blood*
  • Antithyroid Agents / adverse effects*
  • Autoimmune Diseases / chemically induced
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Plasmapheresis
  • Prognosis
  • Propylthiouracil / adverse effects*
  • Risk Factors
  • Vasculitis / chemically induced*
  • Vasculitis / diagnosis
  • Vasculitis / epidemiology
  • Vasculitis / therapy


  • Antibodies, Antineutrophil Cytoplasmic
  • Antithyroid Agents
  • Glucocorticoids
  • Immunosuppressive Agents
  • Propylthiouracil