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Propylthiouracil-induced Otitis Media with Antineutrophil Cytoplasmic Antibody-associated Vasculitis
Rika Tanaka1, Yasuhiro Shimojima1, Hideaki Moteki2
1Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
Abstract:
We herein report a case of otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) induced by propylthiouracil (PTU). A 30-year-old Japanese woman with Graves' disease, who was treated with PTU, reported with otitis media with sensorineural hearing loss bilaterally and trigeminal neuralgia on the left side, as well as elevated serum levels of myeloperoxidase-ANCA. Prior treatment with antibiotics was ineffective even after tympanostomy. However, clinical remission was immediately achieved after initiating prednisolone together with PTU withdrawal. These findings suggest that PTU therapy induces localized otological involvement as the concept of OMAAV.
Insights
Propylthiouracil (PTU) can trigger otitis media with ANCA-associated vasculitis (OMAAV), causing hearing loss and neuralgia. Prompt treatment with steroids and PTU withdrawal led to remission in a Graves
Area of Science:
- Internal Medicine
- Otolaryngology
- Rheumatology
Background:
- Propylthiouracil (PTU) is a common treatment for Graves' disease.
- Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic autoimmune disease.
- Otitis media can sometimes be associated with systemic autoimmune conditions.
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