Pericarditis: Uncommon Onset of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Induced by Methimazol

Abstract

Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of small vessel vasculitides characterized by necrotizing inflammation, with few or no immune deposits associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA. It includes microscopic polyangiitis, granulomatosis with polyangiitis (Wegner’s), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and single-organ AAV (for renal example, renal-limited AAV) [1]. Even the etiology of this vasculitis is still unclear several factors have been reported to be associated with AAV with more consideration of drug-associated ANCAassociated vasculitis [2]. Antithyroid drugs (ATDs) which are generally well tolerated can be associated with minor side effect, but serious and potentially life-threatening complications can occurred in very rare cases with such AAV [3]. To date Propylthiouracil (PTU) is more likely to be associated with AAV than Carbimazole (CBZ) or his active metabolite Methimazole (MMI) [4]. Skin lesions and kidney involvement are the most common clinical features reported in this field. Here we present the first case report of a 25-yr-old woman who developed AAV initially presenting with pericarditis after 1 year of MMI use.