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学科主题: 临床医学
题名:
Long-term outcomes of patients with propylthiouracil-induced anti-neutrophil cytoplasmic auto-antibody-associated vasculitis
作者: Gao, Y.1,2; Chen, M.1; Ye, H.2; Yu, F.1; Guo, X. -h.2; Zhao, M. -h.1
关键词: propylthiouracil ; vasculitis ; antineutrophil cytoplasmic antibodies ; hyperthyroidism ; therapy ; prognosis
刊名: RHEUMATOLOGY
发表日期: 2008-10-01
DOI: 10.1093/rheumatology/ken321
卷: 47, 期:10, 页:1515-1520
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Rheumatology
研究领域[WOS]: Rheumatology
关键词[WOS]: GLOMERULAR-FILTRATION-RATE ; ANCA-POSITIVE VASCULITIS ; DRUG-INDUCED VASCULITIS ; OF-THE-LITERATURE ; ANTITHYROID DRUGS ; CHINESE PATIENTS ; AUTOANTIBODIES ANCA ; TARGET ANTIGENS ; ANTIMYELOPEROXIDASE ANTIBODIES ; MICROSCOPIC POLYANGIITIS
英文摘要:

Objective. It was well known that propylthiouracil (PTU) could induce ANCA-associated vasculitis (AAV) and clinical evident vasculitis could resolve after cessation of PTU with or without immunosuppressive therapy. However, the treatment strategy for patients with PTU-induced AAV remained inconclusive and their long-term outcomes were lacking. The aim of our study was to summarize these data.

Methods.Fifteen patients with PTU-induced AAV, receiving immunosuppressive agents for <12 months and following over 24 months, were selected in the current study. The clinical and pathological data, including treatment protocols and outcomes, were retrospectively investigated.

Results. All the patients were followed for a mean of 55.0 (25-98) months. PTU was discontinued upon diagnosis of PTU-induced AAV. Immunosuppressive therapy was administrated only for patients with vital organ involvements, such as lung and kidney, and lasted only 7.9 +/- 3.3 (0.27-12) months. No relapse of vasculitis occurred during follow-up, even after withdrawal of immunosuppressive therapy. Twelve (80%) patients remained in complete remission and one patient remained in partial remission at the latest follow-up. Two patients were treatment resistant due to late referral and late withdrawal of PTU, both of them progressed to end-stage renal disease. For uncontrolled hyperthyroidism on presentation, six patients switched to methimazole and none of them experienced relapse of vasculitis.

Conclusions. The long-term outcomes of patients with PTU-induced AAV were relatively good. PTU should be discontinued immediately after diagnosis. Immunosuppressive therapy may be only used in patients with vital organ involvements, and a long-term maintenance therapy may not be necessary.

语种: 英语
所属项目编号: 30500459 ; 7082096
项目资助者: National natural science foundation of China ; Beijing Natural Science Foundation
WOS记录号: WOS:000259326600015
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54085
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Dept Nephrol, Beijing 100034, Peoples R China
2.Peking Univ, Hosp 1, Dept Endocrinol, Beijing 100034, Peoples R China

Recommended Citation:
Gao, Y.,Chen, M.,Ye, H.,et al. Long-term outcomes of patients with propylthiouracil-induced anti-neutrophil cytoplasmic auto-antibody-associated vasculitis[J]. RHEUMATOLOGY,2008,47(10):1515-1520.
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