Propylthiouracil-induced ANCA-positive vasculitis in Graves’ disease

Implication for health policy/practice/research/medical education: Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is an infrequent autoimmune disease that involves small vessels. Vasculitis triggers include infections, drugs, and chemicals. Propylthiouracil (PTU) is the most reported drug implicated in the induction of ANCA-associated vasculitis. The involvement of hematological systems, skin, gastrointestinal systems, kidneys, musculoskeletal systems, lungs, and neurological systems are seen in PTU-induced vasculitis. The exact pathogenesis of ANCA induction and PTU-induced vasculitis is not fully understood. Diagnosing PTU-induced ANCA-positive vasculitis involves a combination of clinical, laboratory, imaging, and histopathological findings.