Biopsy-proven Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-associated Vasculitis Overlap Syndrome Developed during Propylthiouracil Therapy: A Case-based Review
Year: 2026
Type: article
Study design: Case Report
Abstract: A 31-year-old woman who had been receiving propylthiouracil (PTU) treatment for Graves' disease was referred to our hospital for the evaluation of hematuria and proteinuria. Laboratory tests showed positivity for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA), proteinase 3-ANCA, and anti-double-stranded DNA antibodies. A kidney biopsy revealed immunocomplex-mediated mesangial proliferative glomerulonephritis, consistent with lupus nephritis (LN) diagnosis. Additionally, tubulitis, peritubular capillaritis without immune complex deposition, and medullary angiitis were observed. We herein describe a case of overlap syndrome of LN and ANCA-associated vasculitis (AAV) that developed during PTU therapy. A detailed histological evaluation, including an examination of the renal medulla, may aid in distinguishing between AAV, LN, and overlap syndromes.
Source: Internal Medicine
Institutions: University of Yamanashi, Nippon Medical School
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214573567