thiouracil and Autoimmune-Diseases

Topics: Adenoma; Alpha-Globulins; Antibody Formation; Antigens; Autoantibodies; Autoimmune Diseases; Beta-Globulins; Blood Proteins; Child; Humans; Hyperthyroidism; Hypothyroidism; Organ Specificity; Serum Globulins; Species Specificity; Thiouracil; Thyroid Function Tests; Thyroid Hormones; Thyroid Neoplasms; Thyroiditis; Thyroiditis, Autoimmune; Thyrotropin; Triiodothyronine

Antineutrophil cytoplasmic antibodies are classical serological markers of small-vessels vasculitis. However, they have been described in many other pathological situations. The aim of this study was to determine through our experience, the main antineutrophil cytoplasmic antibodies-associated diseases and to investigate antigen targets of these antibodies. Forty complete observations of antineutrophil cytoplasmic antibodies (ANCA) positive patients either by indirect immunofluorescence or by enzyme immunoassay were analysed. Only five (12.5%) patients have small-vessels vasculitis. Among these, antineutrophil cytoplasmic antibodies were detected only by Elisa in one patient and they were exclusively directed against bactericidal permeability increasing protein in another one. Our study confirms the presence of antineutrophil cytoplasmic antibodies in different diseases. It demonstrates that antineutrophil cytoplasmic antibodies should be investigated by Elisa when indirect immunofluorescence is negative. In small-vessels vasculitis, Proteinase 3 and myeloperoxidase are mainly but not exclusively the antigenic targets of antineutrophil cytoplasmic antibodies.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Antineutrophil Cytoplasmic; Autoantigens; Autoimmune Diseases; Child; Connective Tissue Diseases; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique, Indirect; Humans; Infections; Inflammation; Male; Mass Screening; Middle Aged; Myeloblastin; Peroxidase; Thiouracil; Vasculitis; Young Adult

Drug induced antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis is a rare complication associated especially with propylthiouracil (PTU). Prevalence of ANCA in patients receiving PTU is well established. Few cases of vasculitis were also reported with benzylthiouracil (BTU). The objective of this study is to clarify the prevalence of ANCA in patients receiving BTU.. ANCA were investigated by indirect immunofluoresence and enzyme linked immunosorbant assay in 159 patients with Graves' disease (86 untreated and 73 treated with BTU).. ANCA were positive in three (3.5%) untreated patients and 27 (37%) treated ones. Titres of ANCA varied between 1:20 and 1:200. There was a significant association between BTU treatment and ANCA (p<0.001). ANCA were directed against myeloperoxidase (MPO) in 28 (93.3%) patients. Median treatment duration was 24 months (ranges 0.5 to 144 months). There was no significant association between treatment duration and ANCA. Vasculitis was found in two (2.7%) treated patients. One patient has developed isolated cutaneous vasculitis and the other one a pulmonary vasculitis with diffuse alveolar haemorrhage.. BTU therapy is characterised by a high prevalence of ANCA mainly but not exclusively directed against MPO. However, vasculitis remains a rare complication.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Antineutrophil Cytoplasmic; Antithyroid Agents; Autoantigens; Autoimmune Diseases; Child; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique, Indirect; Graves Disease; Humans; Male; Middle Aged; Peroxidase; Thiouracil; Vasculitis; Young Adult

Sixteen cases of pediatric hyperthyroidism treated by antithyroid drugs are reported. First-line treatment with carbimazole in a mean dose of 19 mg/m2 initially and 7 mg/m2 after one year ensured control of the disease within 6 weeks. Mean follow-up was 4 years. Only two children were able to discontinue the drug, after 9.1 years and 4.6 years. Two other patients had thyroidectomy, after 6.7 years and 3.4 years. The main disadvantages of antithyroid drugs are the need for prolonged treatment and the risk of recurrence. An attempt at treatment discontinuation is warranted in patients with good disease control of 2 to 3 years duration, goiter size reduction, improved exophthalmos, and decreased anti-TSH receptor antibodies.

Topics: Autoantibodies; Autoimmune Diseases; Body Mass Index; Carbimazole; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Hyperthyroidism; Infant; Male; Recurrence; Thiouracil; Thyroglobulin; Thyroid Function Tests; Thyroidectomy

Topics: Agranulocytosis; Aminopyrine; Antigen-Antibody Complex; Autoantibodies; Autoimmune Diseases; Cytotoxicity Tests, Immunologic; Drug Hypersensitivity; Female; Humans; Hypoglycemic Agents; Infant, Newborn; Isoantibodies; Leukopenia; Lupus Erythematosus, Systemic; Maternal-Fetal Exchange; Pregnancy; Sulfonamides; Thiouracil