Endocrine Abstracts

Background: It was noted in the last few years there was an increased incidence of vasculitis and vasculitic reactions in patients with thyrotoxicosis. Those vasculitic reactions ranged from simple purpuric skin lesion to sever intra-alveolar hemorrhage and even to Steven Johnson Syndrome, Most of those vasculitic reactions occurred in patients receiving propylthiouracil or methimazole. But many other cases were detected in thyrotoxic patients even before starting to receive those medications.

Aim: The aim of this work is to clarify whether the vasculatic lesions associated with hyperthyroidism were due to anti-thyroid medications or due to the hyperthyroid diseases itself or due to both of them.

Methods: This study included 125 subjects divided into 4 groups, group -1 included patients with newly diagnosed autoimmune hyperthyroidism, 2- newly diagnosed non immune hyperthyroidism, 3- patients receiving propylthyouracil and 4- patients receiving methemazol , all routine labs and P-ANCA were done for all the patients as well as the control group

Results: It was found that p ANCA level was higher in patients with autoimmune hyperthyroididism than the non immune hyperthyroidism (P=0.002) also p-ANCA level was higher in patients with protienurea than those with normal urine analysis (P-value 0.01). also p ANCA was significantly higher in patients with both arthralgia and or skin rash, than those without these findings. (P-value <0.01). There was statistically significant positive strong correlation between p-ANCA level and dose of propylthyouracil or methemazol given to treat hyperthyroidism (P-value <0.05) and statistically significant positive correlation between p-ANCA level and duration of treatment (P-value<0.05.) While correlation between p-ANCA and thyroid hormones profiles after controlling of dose and duration of treatment, revealed that There was no statistically significant correlation between p-ANCA level and level of T3, T4 and TSH.

Keywords: P-ANCA, thyrotoxicosis, propylthyouracil and methemazol