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Methimazole-Induced Pauci-Immune Glomerulonephritis and Anti-Phospholipid Syndrome: An Important Association to Be

Huzaif Qaisar1, Mohammad A Hossain1, Monika Akula1

  • 1Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753, USA.

Journal of Clinical Medicine Research
|September 15, 2018
PubMed

Insights

Methimazole (MMI) can cause rare adverse effects like kidney and artery issues. Early MMI withdrawal and treatment with steroids and anticoagulation resolved these severe symptoms.

Area of Science:

  • Nephrology
  • Rheumatology
  • Endocrinology

Background:

  • Methimazole (MMI) is a primary treatment for hyperthyroidism.
  • MMI use is associated with potential adverse effects.
  • Pauci-immune glomerulonephritis is a known MMI-induced complication.

Observation:

  • A 70-year-old male presented with leg pain, rash, renal, and splenic infarcts.
  • The patient had hematuria, proteinuria, and positive MPO, PR3, and anti-cardiolipin antibodies.
  • Renal biopsy showed pauci-immune glomerulonephritis and features of anti-phospholipid antibody syndrome (APS).

Findings:

  • This case highlights a novel association between MMI-induced pauci-immune glomerulonephritis and APS.
  • Discontinuation of MMI was crucial for patient recovery.
  • Successful treatment involved steroids and anticoagulation, resolving renal and vascular complications.

Implications:

  • Early recognition and MMI withdrawal are vital in managing this rare MMI-induced condition.
  • The findings suggest a potential link between MMI, autoimmunity, and thrombotic events.
  • This case expands the understanding of MMI's complex adverse effect profile and treatment strategies.
Keywords:
ANACrescentic glomerulonephritisGlucocorticosteroidsMethimazolePauci-immune

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