Related Experiment Video
Updated: May 24, 2026

Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
Propylthiouracil-induced ANCA-positive erythema nodosum treated with thalidomide
Pengjie Wan1, Xiaoqing Zhao, Ranganna Y P Hunasehally
1Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
Background:
Propylthiouracil (PTU), one of the mainstays of antithyroid therapy drugs, can lead to antineutrophil cytoplasmic antibody (ANCA) positivity and skin lesions. PTU-induced ANCA-positive vasculitis is rare and even more rare is erythema nodosum.
Objective:
To report a case of a 57-year-old woman with hyperthyroidism who developed myeloperoxidase (MPO)-ANCA erythema nodosum after PTU treatment for 11 months.
Methods:
Skin biopsy demonstrated septal panniculitis without vasculitis. PTU-induced ANCA-positive erythema nodosum was made.
Results:
With discontinuation of PTU and initiation of thalidomide, skin lesions resolved completely in three weeks, and after three months, the titers of MPO-ANCA and perinuclear-ANCA (p-ANCA) had decreased remarkably. At 14-month follow-up, the patient was asymptomatic, but low levels of ANCA titers persisted.
Conclusions:
This report indicated that ANCA positive erythema nodosum could develop following PTU treatment. Thalidomide has been proven to be helpful and averted the adverse effects from systemic corticosteroids and other immunosuppressive drugs in this patient.
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