Bariatric surgery is a type of weight loss surgery that is commonly used to treat obesity. However, this surgery can also affect the body’s calcium and PTH metabolism, leading to the development of secondary hyperparathyroidism (SHPT). Several factors contribute to the development of SHPT after bariatric surgery. Malabsorption of calcium due to reduced intestinal surface area, decreased intake of calcium-rich foods, and altered vitamin D metabolism play a significant role. The loss of weight-bearing adipose tissue can also disrupt the balance between bone formation and resorption, leading to increased bone turnover and calcium release from the skeleton. The management of SHPT after bariatric surgery involves a multidisciplinary approach. Calcium and vitamin D supplementation is essential to correct deficiency and maintain bone health. However, achieving optimal calcium and vitamin D levels can be challenging due to malabsorption issues and the need for higher supplementation doses. In some cases, pharmacological interventions such as calcimimetics or PTH analogs may be required to control PTH levels. However, these medications should be used cautiously due to limited data on their safety and efficacy in the bariatric surgery population. Prevention of SHPT is an important aspect of managing patients undergoing bariatric surgery. Nutritional counseling and regular monitoring of calcium, vitamin D, and PTH levels can help identify and address deficiencies early on. Additionally, using procedures that preserve the duodenum and proximal jejunum, such as duodenal switch or biliopancreatic diversion with duodenal switch, may reduce the risk of developing SHPT.
{"title":"Bariatric surgery and secondary hyperparathyroidism; a mini-review","authors":"Ali Azarpey, Mahshid Imankhan, Sina Neshat","doi":"10.34172/jpd.2023.11238","DOIUrl":"https://doi.org/10.34172/jpd.2023.11238","url":null,"abstract":"Bariatric surgery is a type of weight loss surgery that is commonly used to treat obesity. However, this surgery can also affect the body’s calcium and PTH metabolism, leading to the development of secondary hyperparathyroidism (SHPT). Several factors contribute to the development of SHPT after bariatric surgery. Malabsorption of calcium due to reduced intestinal surface area, decreased intake of calcium-rich foods, and altered vitamin D metabolism play a significant role. The loss of weight-bearing adipose tissue can also disrupt the balance between bone formation and resorption, leading to increased bone turnover and calcium release from the skeleton. The management of SHPT after bariatric surgery involves a multidisciplinary approach. Calcium and vitamin D supplementation is essential to correct deficiency and maintain bone health. However, achieving optimal calcium and vitamin D levels can be challenging due to malabsorption issues and the need for higher supplementation doses. In some cases, pharmacological interventions such as calcimimetics or PTH analogs may be required to control PTH levels. However, these medications should be used cautiously due to limited data on their safety and efficacy in the bariatric surgery population. Prevention of SHPT is an important aspect of managing patients undergoing bariatric surgery. Nutritional counseling and regular monitoring of calcium, vitamin D, and PTH levels can help identify and address deficiencies early on. Additionally, using procedures that preserve the duodenum and proximal jejunum, such as duodenal switch or biliopancreatic diversion with duodenal switch, may reduce the risk of developing SHPT.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135958004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Implication for health policy/practice/research/medical education: Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is an infrequent autoimmune disease that involves small vessels. Vasculitis triggers include infections, drugs, and chemicals. Propylthiouracil (PTU) is the most reported drug implicated in the induction of ANCA-associated vasculitis. The involvement of hematological systems, skin, gastrointestinal systems, kidneys, musculoskeletal systems, lungs, and neurological systems are seen in PTU-induced vasculitis. The exact pathogenesis of ANCA induction and PTU-induced vasculitis is not fully understood. Diagnosing PTU-induced ANCA-positive vasculitis involves a combination of clinical, laboratory, imaging, and histopathological findings.
{"title":"Propylthiouracil-induced ANCA-positive vasculitis in Graves’ disease","authors":"Leila Alem","doi":"10.34172/jpd.2023.11241","DOIUrl":"https://doi.org/10.34172/jpd.2023.11241","url":null,"abstract":"Implication for health policy/practice/research/medical education: Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is an infrequent autoimmune disease that involves small vessels. Vasculitis triggers include infections, drugs, and chemicals. Propylthiouracil (PTU) is the most reported drug implicated in the induction of ANCA-associated vasculitis. The involvement of hematological systems, skin, gastrointestinal systems, kidneys, musculoskeletal systems, lungs, and neurological systems are seen in PTU-induced vasculitis. The exact pathogenesis of ANCA induction and PTU-induced vasculitis is not fully understood. Diagnosing PTU-induced ANCA-positive vasculitis involves a combination of clinical, laboratory, imaging, and histopathological findings.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76669401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary hyperparathyroidism (PHPT) is a condition characterized by the parathyroid glands’ overproduction of parathyroid hormone (PTH). These increases calcium levels in the blood, leading to various symptoms and complications. Cinacalcet is a promising therapeutic option for patients with PHPT who are unable or unwilling to undergo surgery. It effectively reduces serum calcium and PTH levels, improving biochemical markers of bone turnover and renal function. However, more research is needed to determine the optimal dosage, duration, and long-term effects of cinacalcet treatment in this patient population. Clinicians should carefully consider the risks and benefits of cinacalcet therapy individually and involve patients in shared decision-making.
{"title":"Cinacalcet in patients with primary hyperparathyroidism; a review","authors":"H. Hemmati","doi":"10.34172/jpd.2023.11226","DOIUrl":"https://doi.org/10.34172/jpd.2023.11226","url":null,"abstract":"Primary hyperparathyroidism (PHPT) is a condition characterized by the parathyroid glands’ overproduction of parathyroid hormone (PTH). These increases calcium levels in the blood, leading to various symptoms and complications. Cinacalcet is a promising therapeutic option for patients with PHPT who are unable or unwilling to undergo surgery. It effectively reduces serum calcium and PTH levels, improving biochemical markers of bone turnover and renal function. However, more research is needed to determine the optimal dosage, duration, and long-term effects of cinacalcet treatment in this patient population. Clinicians should carefully consider the risks and benefits of cinacalcet therapy individually and involve patients in shared decision-making.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79451584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vitamin D is essential for regulating calcium and phosphate metabolism, and its deficiency or excess can significantly affect parathyroid function. The deficiency or insufficiency of vitamin D can lead to increased parathyroid hormone (PTH) production, resulting in secondary hyperparathyroidism. Conversely, adequate vitamin D levels suppress PTH synthesis and maintain normal calcium levels. Dysregulation of this delicate balance can contribute to various disorders such as osteoporosis, renal stones, and skeletal abnormalities. Hence, understanding the complex interactions between vitamin D and the parathyroid glands is important for diagnosing and managing disorders such as primary and secondary hyperparathyroidism.
{"title":"Interactions of vitamin D with parathyroid glands; an updated mini-review","authors":"H. Hemmati","doi":"10.34172/jpd.2023.11228","DOIUrl":"https://doi.org/10.34172/jpd.2023.11228","url":null,"abstract":"Vitamin D is essential for regulating calcium and phosphate metabolism, and its deficiency or excess can significantly affect parathyroid function. The deficiency or insufficiency of vitamin D can lead to increased parathyroid hormone (PTH) production, resulting in secondary hyperparathyroidism. Conversely, adequate vitamin D levels suppress PTH synthesis and maintain normal calcium levels. Dysregulation of this delicate balance can contribute to various disorders such as osteoporosis, renal stones, and skeletal abnormalities. Hence, understanding the complex interactions between vitamin D and the parathyroid glands is important for diagnosing and managing disorders such as primary and secondary hyperparathyroidism.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77274271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Secondary hyperparathyroidism is a common complication of chronic kidney disease characterized by excessive secretion of parathyroid hormone from the parathyroid glands. Cinacalcet is a calcimimetic medication that reduces parathormone levels by increasing the sensitivity of the calcium-sensing receptors on the parathyroid glands. This review aims to summarize the existing literature on the use of cinacalcet in patients with secondary hyperparathyroidism.
{"title":"Cinacalcet in patients with secondary hyperparathyroidism; a review","authors":"H. Hemmati","doi":"10.34172/jpd.2023.11227","DOIUrl":"https://doi.org/10.34172/jpd.2023.11227","url":null,"abstract":"Secondary hyperparathyroidism is a common complication of chronic kidney disease characterized by excessive secretion of parathyroid hormone from the parathyroid glands. Cinacalcet is a calcimimetic medication that reduces parathormone levels by increasing the sensitivity of the calcium-sensing receptors on the parathyroid glands. This review aims to summarize the existing literature on the use of cinacalcet in patients with secondary hyperparathyroidism.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84143916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soheil Abdollahi Yeganeh, A. Dehghan, J. Jahanshahi, Sepehr Shirouei, Mahdi Arjipour, S. Borzouei
Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytic disorder with no actual known incidence rate. It primarily affects multiple organs via increased expression of proinflammatory cytokines, eventually leading to histiocyte activation and infiltration at multiple sites. A 31-year-old virgin female presented with progressive generalized bone pain and blurred vision. She underwent a comprehensive clinical and paraclinical evaluation. Based on the final results, the diagnosis of ECD was established. We started treatment mainly using Interferon-α and corticosteroids, estrogen, levothyroxine, and desmopressin acetate. In adults with a mysterious chronic disease affecting multiple organs, we should always consider ECD as a differential diagnosis. Although ECD is still rare, the detection rate of this disease has increased significantly in recent decades. A comprehensive clinical and paraclinical evaluation is necessary to make a definitive diagnosis and determine the extent of the disease.
{"title":"Erdheim-Chester disease; a 31-year-old woman presented with bone pain and ophthalmologic involvement: a case report","authors":"Soheil Abdollahi Yeganeh, A. Dehghan, J. Jahanshahi, Sepehr Shirouei, Mahdi Arjipour, S. Borzouei","doi":"10.34172/jpd.2023.11209","DOIUrl":"https://doi.org/10.34172/jpd.2023.11209","url":null,"abstract":"Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytic disorder with no actual known incidence rate. It primarily affects multiple organs via increased expression of proinflammatory cytokines, eventually leading to histiocyte activation and infiltration at multiple sites. A 31-year-old virgin female presented with progressive generalized bone pain and blurred vision. She underwent a comprehensive clinical and paraclinical evaluation. Based on the final results, the diagnosis of ECD was established. We started treatment mainly using Interferon-α and corticosteroids, estrogen, levothyroxine, and desmopressin acetate. In adults with a mysterious chronic disease affecting multiple organs, we should always consider ECD as a differential diagnosis. Although ECD is still rare, the detection rate of this disease has increased significantly in recent decades. A comprehensive clinical and paraclinical evaluation is necessary to make a definitive diagnosis and determine the extent of the disease.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74349122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus is a common illness, and the number of people affected by this condition is expected to increase significantly. Complications associated with type 2 diabetes mellitus, such as cataracts, retinopathy, neuropathy, and orthostatic hypotension, can increase the risk of falls and subsequent bone fractures. Canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and ipragliflozin are a group of medications known as sodium-glucose cotransporter-2 inhibitors (SGLT-2i), which are oral drugs used to treat type 2 diabetes mellitus. This group of medications is a recent addition to the current treatment options for this condition. There are concerns about the impact of SGLT-2 inhibitors on bone health. Although drugs in this category have similarities in reducing blood glucose and preventing cardiovascular disease, they can have varying effects on bone metabolism. The effect of SGLT-2 inhibitors (SGLT-2is)-induced weight loss on bone mineral density (BMD) and bone turnover is significant and cannot be disregarded. Although SGLT-2 inhibitors were initially predicted to increase the likelihood of bone fractures, clinical evidence contradicts this assumption. It is noteworthy to emphasize that empagliflozin and dapagliflozin did not indicate an increased risk of fractures. It is also interesting to note that SGLT2i drugs positively affect heart function and can reduce the incidence of heart failure, which can lead to a decrease in osteoporosis and bone fractures. Based on clinical trials and real-world evidence, there does not appear to be a link between the administration of SGLT2 inhibitors and the risk of fractures. However, caution should still be exercised when prescribing these drugs to patients with advanced disease or kidney complications who may be at higher risk of bone fractures. It is always important to consider individual patient factors and potential risks before making treatment decisions.
{"title":"Effect of sodium-glucose transporter 2 inhibitors on bone","authors":"Mahdi Baradaranfard, Taha Ameli","doi":"10.34172/jpd.2023.11225","DOIUrl":"https://doi.org/10.34172/jpd.2023.11225","url":null,"abstract":"Diabetes mellitus is a common illness, and the number of people affected by this condition is expected to increase significantly. Complications associated with type 2 diabetes mellitus, such as cataracts, retinopathy, neuropathy, and orthostatic hypotension, can increase the risk of falls and subsequent bone fractures. Canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and ipragliflozin are a group of medications known as sodium-glucose cotransporter-2 inhibitors (SGLT-2i), which are oral drugs used to treat type 2 diabetes mellitus. This group of medications is a recent addition to the current treatment options for this condition. There are concerns about the impact of SGLT-2 inhibitors on bone health. Although drugs in this category have similarities in reducing blood glucose and preventing cardiovascular disease, they can have varying effects on bone metabolism. The effect of SGLT-2 inhibitors (SGLT-2is)-induced weight loss on bone mineral density (BMD) and bone turnover is significant and cannot be disregarded. Although SGLT-2 inhibitors were initially predicted to increase the likelihood of bone fractures, clinical evidence contradicts this assumption. It is noteworthy to emphasize that empagliflozin and dapagliflozin did not indicate an increased risk of fractures. It is also interesting to note that SGLT2i drugs positively affect heart function and can reduce the incidence of heart failure, which can lead to a decrease in osteoporosis and bone fractures. Based on clinical trials and real-world evidence, there does not appear to be a link between the administration of SGLT2 inhibitors and the risk of fractures. However, caution should still be exercised when prescribing these drugs to patients with advanced disease or kidney complications who may be at higher risk of bone fractures. It is always important to consider individual patient factors and potential risks before making treatment decisions.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77770343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The fibrotic impact of parathyroid hormone (PTH) excess is an important aspect of primary hyperparathyroidism (PHPT) that can contribute to organ dysfunction and morbidity. Understanding the underlying mechanisms of PTH-induced fibrosis and identifying potential therapeutic targets may pave the way for novel treatment strategies. Further research is needed to elucidate the complex interactions between PTH and fibrotic pathways and to evaluate the efficacy of targeted interventions in preventing or reversing fibrosis associated with PHPT. The fibrotic impact of PTH excess is observed across multiple organ systems. Fibrosis resulting from PTH excess can impair organ function and lead to significant morbidity and mortality. Understanding the underlying mechanisms involved in PTH-induced fibrosis is crucial for developing targeted therapies to mitigate its detrimental effects.
{"title":"Mechanistic impact of fibrosis by parathyroid hormone excess","authors":"A. Baradaran","doi":"10.34172/jpd.2023.11231","DOIUrl":"https://doi.org/10.34172/jpd.2023.11231","url":null,"abstract":"The fibrotic impact of parathyroid hormone (PTH) excess is an important aspect of primary hyperparathyroidism (PHPT) that can contribute to organ dysfunction and morbidity. Understanding the underlying mechanisms of PTH-induced fibrosis and identifying potential therapeutic targets may pave the way for novel treatment strategies. Further research is needed to elucidate the complex interactions between PTH and fibrotic pathways and to evaluate the efficacy of targeted interventions in preventing or reversing fibrosis associated with PHPT. The fibrotic impact of PTH excess is observed across multiple organ systems. Fibrosis resulting from PTH excess can impair organ function and lead to significant morbidity and mortality. Understanding the underlying mechanisms involved in PTH-induced fibrosis is crucial for developing targeted therapies to mitigate its detrimental effects.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"513 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72582202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Klotho is a protein that has been found to play a role in regulating parathyroid hormone (PTH) levels. The literature suggests an intricate relationship between Klotho and PTH. Klotho acts as a co-receptor for fibroblast growth factor 23 (FGF23), a hormone that helps regulate phosphate and vitamin D metabolism. Klotho deficiency has been associated with increased PTH levels and secondary hyperparathyroidism. Several studies have investigated the relationship between Klotho and PTH levels. Some studies have shown that Klotho levels are inversely correlated with PTH levels, suggesting that higher Klotho levels may lead to lower PTH levels. Other studies have found that Klotho deficiency can contribute to PTH resistance, leading to persistent hyperparathyroidism. Additionally, the Klotho-PTH axis holds promise as a potential target for therapeutic interventions in calcium and phosphate disorders.
{"title":"Mechanistic impact of fibrosis by parathyroid hormone excess","authors":"Azar Baradaran","doi":"10.34172/jpd.2023.11230","DOIUrl":"https://doi.org/10.34172/jpd.2023.11230","url":null,"abstract":"Klotho is a protein that has been found to play a role in regulating parathyroid hormone (PTH) levels. The literature suggests an intricate relationship between Klotho and PTH. Klotho acts as a co-receptor for fibroblast growth factor 23 (FGF23), a hormone that helps regulate phosphate and vitamin D metabolism. Klotho deficiency has been associated with increased PTH levels and secondary hyperparathyroidism. Several studies have investigated the relationship between Klotho and PTH levels. Some studies have shown that Klotho levels are inversely correlated with PTH levels, suggesting that higher Klotho levels may lead to lower PTH levels. Other studies have found that Klotho deficiency can contribute to PTH resistance, leading to persistent hyperparathyroidism. Additionally, the Klotho-PTH axis holds promise as a potential target for therapeutic interventions in calcium and phosphate disorders.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135265491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kalbasi, A. Tajik, S. Ahmadi, Hamidreza Khodabandeh, Nafiseh Zare, Manuchehr Bashirynejad
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is rare, but it can be triggered by chemicals, infections, and drugs. Patients who use anti-thyroid drugs are prone to involve with ANCA-associated vasculitis. Perinuclear ANCA (p-ANCA) is almost always positive in these patients. Patients have various presentations and symptoms such as (arthritis, edema) and this disorder usually resolves with discontinuation of the drug, however, some patients require high-dose steroids, immunosuppressive or plasmapheresis. A 38-year-old woman with a history of Graves’ disease was on long-term treatment with propylthiouracil (PTU), presented with severe bone pain, arthritis and edema in both feet. The patient’s manifestations were resolved with discontinuation of PTU, iodine therapy, and corticosteroid administration.
{"title":"Propylthiouracil induced ANCA-positive vasculitis in a patient with Graves’ disease; a case report","authors":"S. Kalbasi, A. Tajik, S. Ahmadi, Hamidreza Khodabandeh, Nafiseh Zare, Manuchehr Bashirynejad","doi":"10.34172/jpd.2023.11233","DOIUrl":"https://doi.org/10.34172/jpd.2023.11233","url":null,"abstract":"Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is rare, but it can be triggered by chemicals, infections, and drugs. Patients who use anti-thyroid drugs are prone to involve with ANCA-associated vasculitis. Perinuclear ANCA (p-ANCA) is almost always positive in these patients. Patients have various presentations and symptoms such as (arthritis, edema) and this disorder usually resolves with discontinuation of the drug, however, some patients require high-dose steroids, immunosuppressive or plasmapheresis. A 38-year-old woman with a history of Graves’ disease was on long-term treatment with propylthiouracil (PTU), presented with severe bone pain, arthritis and edema in both feet. The patient’s manifestations were resolved with discontinuation of PTU, iodine therapy, and corticosteroid administration.","PeriodicalId":16657,"journal":{"name":"Journal of Parathyroid Disease","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75510499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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