CHIN-CHUNG SHUWeng S.-F.SONG-CHOU HSIEHTIEN-SHANG HUANG2020-06-032020-06-0320051016-7390https://www.scopus.com/inward/record.uri?eid=2-s2.0-30944467269&partnerID=40&md5=53b9496106f16f0c2e4083d595d3bb83https://scholars.lib.ntu.edu.tw/handle/123456789/496822Propylthiouracil (PTU) is a thionamide used for hyperthyroidism. Numbers of PTU induced adverse reactions such as leukopenia, rash, fever, arthritis, vasculitis, and lupus-like syndrome are reported. In addition, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis during PTU therapy was reported. Pulmonary-renal syndrome is one infrequent but life-threatening presentation of PTU-associated ANCA-positive vasculitis. We report a 45-year-old woman with pulmonary-renal syndrome presented as hemoptysis, normocytic anemia, and microscopic hematuria during the treatment of Graves' disease with PTU. Her serum perinuclear-ANCA was positive and dysmorphic red blood cells were found in urinalysis. After discontinuing PTU and starting immunosuppressive agent treatment, the fever, hematuria, and pulmonary hemorrhage subsided but the p-ANCA was still present several months later. ANCA-associated pulmonary-renal syndrome may be a complication of PTU therapy. The proportion of ANCA-positive case increases with the prolongation of PTU therapy. In contrast, there are rare reports of ANCA-associated vasculitis in the other thionamide i.e. carbimazole and methimazole. Therefore, carbimazole or methimazole may be the drug of choice when long-term treatment for hyperthyroidism is required.[SDGs]SDG3acetylsalicylic acid; azithromycin; C reactive protein; carbimazole; creatinine; cyclophosphamide; glucocorticoid; hemoglobin; hydroxychloroquine; immunosuppressive agent; iodine 131; liothyronine; methylprednisolone; neutrophil cytoplasmic antibody; nitrogen; propylthiouracil; sultamicillin; thiamazole; thyrotropin; thyroxine; urea; adult; ANCA associated vasculitis; anemia; arthralgia; article; capillaritis; case report; computer assisted tomography; drug dose regimen; drug fatality; drug withdrawal; erythrocyte volume; exophthalmos; eye disease; female; fever; glomerulonephritis; Graves disease; hematuria; hemoptysis; human; leukocyte count; low drug dose; lung hemorrhage; lung tuberculosis; microscopic polyangiitis; myalgia; partial thromboplastin time; pneumonia; rhinorrhea; sore throat; thorax radiography; thrombocyte count; urea nitrogen blood level; urinalysis; urticariajournal article2-s2.0-30944467269