methimazole and Skin-Diseases--Vascular

Topics: Humans; Methimazole; Skin Diseases, Vascular; Vasculitis, Leukocytoclastic, Cutaneous

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been recently recognized in Graves' disease patients treated with antithyroid drugs. We describe the case of an 18-year-old girl who developed antimyeloperoxidase ANCA (MPO-ANCA)-positive vasculitis manifesting as a skin lesion and hemoptysis with hypoxic respiratory failure after taking methimazole. An open lung biopsy was consistent with acute capillaritis. Both skin and sural nerve biopsy showed lymphocytic vasculitis. Administration of steroid and plasmapheresis produced a good clinical response.

Topics: Adolescent; Antibodies, Antineutrophil Cytoplasmic; Antithyroid Agents; Autoantibodies; Female; Hemorrhage; Humans; Lung Diseases; Methimazole; Peroxidase; Skin Diseases, Vascular; Vasculitis

Cryofibrinogenemia is a cryopathy in which hypersensitivity to cold is a prominent feature. Cryofibrinogenemia developed in an 18-year-old Japanese female patient during methimazole therapy for Graves' disease. She developed cryopathy (livedo reticularis, Raynaud's phenomenon and acral ulcer) and polyarthralgia during methimazole therapy, and we detected cryofibrinogen in her plasma. Her symptoms resolved after administration of prostaglandins and anticoagulants. Several reports indicate that methimazole therapy induces autoantibody-related disease. In the present case, we cannot exclude the possibility that methimazole therapy contributed to the cryofibrinogenemia.

Topics: Adolescent; Anticoagulants; Antithyroid Agents; Arthralgia; Cryoglobulins; Female; Fibrinogens, Abnormal; Foot Ulcer; Graves Disease; Humans; Methimazole; Prostaglandins, Synthetic; Raynaud Disease; Skin Diseases, Vascular