Sweet's syndrome associated with propylthiouracil-induced antineutrophil cytoplasmic antibody



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MODERN　RHEUMATOLOGY Vol.14　No.4

>MR14-4

Sweet's syndrome associated with propylthiouracil-induced antineutrophil cytoplasmic antibody

Masahiro Yamashita1,2 , Shigeko Inokuma2 and Noriko Matsumura3

(1) Department of Internal Medicine, Saka General Hospital, 16-5 Nishikicho, Shiogama, 985-8506, Japan
(2) Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
(3) Department of Dermatology, National Sendai Hospital, Sendai, Japan
(4) Present address: Department of Rheumatology and Haematology, Tohoku University School of Medicine, 2-1 Seiryocho, Aoba-ku, Sendai, 980-8575, Japan

Received: 04 December 2003 Accepted: 18 May 2004

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Abstract

A 44-year-old woman had tender erythematous nodules in both the upper and lower extremities, headache, and fever during the course of propylthiouracil therapy for Graves' disease. Serologic tests showed high titers of antineutrophil cytoplasmic antibody (ANCA) against myeloperoxidase (MPO). A skin biopsy showed neutrophilic dermatitis consistent with Sweet's syndrome. After the cessation of propylthiouracil therapy and the administration of steroids, all her symptoms disappeared and the titer of antineutrophil cytoplasmic antibody against myeloperoxidase decreased. A causal relationship between propylthiouracil (PTU) therapy and Sweet's syndrome is suggested.

Key words

Antineutrophil cytoplasmic antibody (ANCA) - Graves' disease - Propylthiouracil (PTU) - Sweet's syndrome - Vasculitis

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