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Propylthiouracil-associated eosinophilic pleural effusion: a case report
Nazan Sen1, Hilal Ermis, Meltem Karatasli
1Department of Chest Diseases, Baskent University Faculty of Medicine, Ankara, Turkey. nazansen68@gmail.com
Respiration; International Review of Thoracic Diseases
|January 24, 2007
Summary
Long-term propylthiouracil (PTU) use can cause eosinophilic pleural effusion (EPE). Steroid therapy effectively treated this rare drug-induced condition, even after PTU withdrawal.
Area of Science:
- Endocrinology
- Pulmonology
- Pharmacology
Background:
- Graves' disease is commonly treated with antithyroid drugs like propylthiouracil (PTU).
- Drug-induced pleural effusions are rare but serious adverse effects.
- Eosinophilic pleural effusion (EPE) is characterized by a high percentage of eosinophils in pleural fluid.
Observation:
- A 43-year-old woman with an 11-year history of PTU treatment for Graves' disease presented with chest pain and right-sided pleural effusion.
- Thoracentesis confirmed eosinophilic pleural effusion (EPE).
- Other causes of EPE were ruled out through comprehensive medical evaluation.
Findings:
- Discontinuation of PTU did not immediately resolve the EPE, which persisted for 6 weeks.
- Short-term corticosteroid therapy led to the resolution of the pleural effusion.
- Re-administration of PTU resulted in recurrent EPE, confirming its causative role.
- Subsequent treatment with methimazole and a brief course of corticosteroids led to complete resolution and no recurrence over a 1-year follow-up.
Implications:
- This case highlights a rare adverse effect of long-term propylthiouracil (PTU) use, specifically eosinophilic pleural effusion (EPE).
- The findings suggest that corticosteroid therapy can be an effective treatment for drug-induced EPE.
- This report underscores the importance of considering medication side effects in patients presenting with unexplained pleural effusions, even after prolonged drug exposure.
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