Biopsy-proven Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-associated Vasculitis Overlap Syndrome Developed during Propylthiouracil Therapy: A Case-based Review
Abstract
A 31-year-old woman who had been receiving propylthiouracil (PTU) treatment for Graves' disease was referred to our hospital for the evaluation of hematuria and proteinuria. Laboratory tests showed positivity for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA), proteinase 3-ANCA, and anti-double-stranded DNA antibodies. A kidney biopsy revealed immunocomplex-mediated mesangial proliferative glomerulonephritis, consistent with lupus nephritis (LN) diagnosis. Additionally, tubulitis, peritubular capillaritis without immune complex deposition, and medullary angiitis were observed. We herein describe a case of overlap syndrome of LN and ANCA-associated vasculitis (AAV) that developed during PTU therapy. A detailed histological evaluation, including an examination of the renal medulla, may aid in distinguishing between AAV, LN, and overlap syndromes.
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BibTeX
@article{yoshida2026biopsyproven,
title = {{Biopsy-proven Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-associated Vasculitis Overlap Syndrome Developed during Propylthiouracil Therapy: A Case-based Review}},
author = {Shun Yoshida and Daichi Nakagomi and Motohiro Ueda and Kengo Asahina and Keiichi Osano and Toshihisa Ishii and Makiko Konishi and Kazuya Takahashi and Akira Shimizu and Ayumu Nakashima},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7792-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7792-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Biopsy-proven Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-associated Vasculitis Overlap Syndrome Developed during Propylthiouracil Therapy: A Case-based Review
AU - Shun Yoshida
AU - Daichi Nakagomi
AU - Motohiro Ueda
AU - Kengo Asahina
AU - Keiichi Osano
AU - Toshihisa Ishii
AU - Makiko Konishi
AU - Kazuya Takahashi
AU - Akira Shimizu
AU - Ayumu Nakashima
PY - 2026
DA - 2026/09/29
JO - Internal Medicine
DO - 10.2169/internalmedicine.7792-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7792-26/_article
AB - A 31-year-old woman who had been receiving propylthiouracil (PTU) treatment for Graves' disease was referred to our hospital for the evaluation of hematuria and proteinuria. Laboratory tests showed positivity for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA), proteinase 3-ANCA, and anti-double-stranded DNA antibodies. A kidney biopsy revealed immunocomplex-mediated mesangial proliferative glomerulonephritis, consistent with lupus nephritis (LN) diagnosis. Additionally, tubulitis, peritubular capillaritis without immune complex deposition, and medullary angiitis were observed. We herein describe a case of overlap syndrome of LN and ANCA-associated vasculitis (AAV) that developed during PTU therapy. A detailed histological evaluation, including an examination of the renal medulla, may aid in distinguishing between AAV, LN, and overlap syndromes.
SN - 1349-7235
SN - 0918-2918
ER -