{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:01:37Z","timestamp":1785240097503,"version":"3.55.0"},"reference-count":11,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Propylthiouracil (PTU), an antithyroid medication used in managing Graves disease, can rarely cause antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), a potentially serious complication. We report a case of a 54-year-old woman with Graves disease on long-term PTU therapy who developed a progressive purpuric rash and polyarthralgia. Laboratory tests showed elevated inflammatory markers and positive results for perinuclear ANCA (p-ANCA) and myeloperoxidase antibodies. A skin biopsy confirmed leukocytoclastic vasculitis. Symptoms improved after the discontinuation of PTU and initiation of corticosteroid therapy. The patient subsequently underwent total thyroidectomy for definitive treatment of Graves disease. This case highlights the importance of considering PTU-induced AAV in patients with vasculitic rashes, even after years of stable therapy. Early detection, prompt discontinuation of the medication, and multidisciplinary collaboration are essential to prevent disease progression and ensure favorable outcomes.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag210","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:29:58Z","timestamp":1784633398000},"source":"Crossref","is-referenced-by-count":0,"title":["Propylthiouracil-induced myeloperoxidase antineutrophil cytoplasmic antibody-associated leukocytoclastic vasculitis"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0925-0075","authenticated-orcid":false,"given":"Osadebamwen","family":"Osaghae","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Tower Health\u2014Reading Hospital , West Reading, PA 19611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafiza","family":"Qadeer","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tower Health\u2014Reading Hospital , West Reading, PA 19611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chheki","family":"Sherpa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tower Health\u2014Reading Hospital , West Reading, PA 19611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Emkey","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tower Health\u2014Reading Hospital , West Reading, PA 19611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Brenan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tower Health\u2014Reading Hospital , West Reading, PA 19611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinita","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tower Health\u2014Reading Hospital , West Reading, PA 19611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"15","key":"2026072807144260100_luag210-B1","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1001\/jama.2023.19052","article-title":"Hyperthyroidism: a review","volume":"330","author":"Lee","year":"2023","journal-title":"JAMA"},{"issue":"17","key":"2026072807144260100_luag210-B2","doi-asserted-by":"crossref","first-page":"e15328","DOI":"10.1097\/MD.0000000000015328","article-title":"A case report of dysregulated neutrophil extracellular traps in a patient with propylthiouracil-induced anti-neutrophil cytoplasmic antibody-associated vasculitis","volume":"98","author":"Watanabe-Kusunoki","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"3","key":"2026072807144260100_luag210-B3","doi-asserted-by":"crossref","first-page":"e678","DOI":"10.1097\/BCR.0000000000000464","article-title":"Propylthiouracil-associated leukocytoclastic necrotizing cutaneous vasculitis: a case report and review of the literature","volume":"38","author":"Wall","year":"2017","journal-title":"J Burn Care Res"},{"issue":"12","key":"2026072807144260100_luag210-B4","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1089\/thy.2017.0468","article-title":"Clinical characteristics and outcomes of propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis in patients with Graves\u2019 disease: a median 38-month retrospective cohort study from a single institution in China","volume":"27","author":"Yang","year":"2017","journal-title":"Thyroid"},{"issue":"8","key":"2026072807144260100_luag210-B5","doi-asserted-by":"crossref","first-page":"2806","DOI":"10.1210\/jc.2008-2700","article-title":"Clinical characteristics of myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis caused by antithyroid drugs","volume":"94","author":"Noh","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2026072807144260100_luag210-B6","first-page":"e27073","article-title":"Propylthiouracil-induced skin vasculitis","volume":"14","author":"Almeida","year":"2022","journal-title":"Cureus"},{"issue":"8","key":"2026072807144260100_luag210-B7","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1038\/nrneph.2012.108","article-title":"Propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis","volume":"8","author":"Chen","year":"2012","journal-title":"Nat Rev Nephrol"},{"issue":"3","key":"2026072807144260100_luag210-B8","doi-asserted-by":"crossref","first-page":"558","DOI":"10.3899\/jrheum.110931","article-title":"Propylthiouracil-induced antineutrophil cytoplasmic antibody (ANCA)-associated renal vasculitis versus primary ANCA-associated renal vasculitis: a comparative study","volume":"39","author":"Chen","year":"2012","journal-title":"J Rheumatol"},{"issue":"1","key":"2026072807144260100_luag210-B9","doi-asserted-by":"crossref","first-page":"103924","DOI":"10.1016\/j.autrev.2025.103924","article-title":"Drug- and vaccine induced ANCA-associated vasculitis: an overview","volume":"25","author":"Cohen Tervaert","year":"2026","journal-title":"Autoimmun Rev"},{"issue":"1","key":"2026072807144260100_luag210-B10","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s40842-024-00215-3","article-title":"Propylthiouracil-induced vasculitis with alveolar hemorrhage after 31 years of treatment: a case report","volume":"10","author":"Khalaf","year":"2024","journal-title":"Clin Diabetes Endocrinol"},{"issue":"12","key":"2026072807144260100_luag210-B11","first-page":"2451","article-title":"Propylthiouracil-associated antineutrophil cytoplasmic autoantibody-positive vasculitis: retrospective study of 19 cases","volume":"34","author":"Chen","year":"2007","journal-title":"J Rheumatol"}],"container-title":["JCEM Case 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