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CASE REPORT article
Front. Med.
Sec. Hematology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1578726
This article is part of the Research Topic Vascular Injury in Systemic Diseases: Current Concepts and Future Perspectives View all 7 articles
Propylthiouracil-Induced ANCA-Associated Vasculitis Complicated by Granulocytopenia and Hemophagocytosis: A Case Report
Provisionally accepted- 1 Second Affiliated Hospital of Hainan Medical University, Haikou, China
- 2 Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou, Hainan Province, China
To analyze a rare case of ANCA-associated vasculitis (AAV) complicated by hemophagocytosis and granulocytopenia induced by long-term propylthiouracil (PTU) therapy, providing insights for clinical diagnosis and management.Methods: A retrospective analysis was conducted on the clinical data and treatment course of a patient who developed AAV with hemophagocytosis and granulocytopenia after prolonged PTU use.Results: Upon admission, granulocytopenia secondary to PTU was suspected. Despite transient recovery of leukocyte counts with anti-infective therapy and granulocyte colony-stimulating factor (G-CSF), recurrent leukopenia and intermittent fever persisted. Bone marrow aspiration revealed hemophagocytic cells, while serologic testing showed positivity for both PR3-ANCA and MPO-ANCA. A definitive diagnosis of PTU-induced AAV was established. Glucocorticoid therapy normalized body temperature and restored leukocyte levels. Follow-up demonstrated resolution of thyrotoxicosis, stabilized leukocyte counts, and afebrile status.Long-term PTU therapy may trigger AAV accompanied by hemophagocytosis. Clinicians should consider screening for hemophagocytic lymphohistiocytosis (HLH) in such cases to guide timely immunosuppressive intervention.
Keywords: ANCA-associated vasculitis,, Propylthiouracil, hemophagocytosis, Hyperthyroidism, Granulocytopenia
Received: 19 Feb 2025; Accepted: 24 Mar 2025.
Copyright: © 2025 Zhou, Lai, Chen, Wang, Fu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shasha Fu, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou, Hainan Province, China
Zongcun Chen, Second Affiliated Hospital of Hainan Medical University, Haikou, China
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