Chest
Volume 139, Issue 3, March 2011, Pages 687-690
Journal home page for Chest

Selected Reports
Propylthiouracil-Induced Nonspecific Interstitial Pneumonia

https://doi.org/10.1378/chest.10-1558Get rights and content

Propylthiouracil (PTU) is a drug used to treat hyperthyroidism. A number of adverse effects have been reported with this drug, including fever, agranulocytosis, skin rash, and vasculitis. PTU-induced interstitial pneumonia is rare—only three cases have been reported—and PTU-induced nonspecific interstitial pneumonia (NSIP) has not been reported. We report a patient who developed NSIP after taking PTU for 1 year. She developed dyspnea, cough, and mild fever lasting 1 month, and a chest CT scan showed multifocal patchy consolidation in both lungs. She underwent a surgical lung biopsy, and NSIP was confirmed pathologically. The symptoms and abnormalities seen in the chest radiograph improved after withdrawal of PTU. To our knowledge, this is the first documented case of pathologically proven PTU-induced NSIP.

Section snippets

Case Report

A 62-year-old Asian woman was admitted for dyspnea and cough of 1 month duration. One year before presentation, she received a diagnosis of hyperthyroidism, and she was since treated with propylthiouracil (PTU) (100 mg/d). She had no other specific medical history except hypertension, which was not treated, and she reported no other concomitant medications. She had never smoked and had no specific occupational history. On admission, her vital signs were stable, with oxygen saturation of 97% on

Discussion

PTU is a thioamide drug that suppresses the synthesis of thyroid hormone by inhibiting iodine binding to tyrosine. It has been suggested that the enzymatic action of myeloperoxidase causes the chemical transformation of PTU to a cytotoxic product1; however, the mechanism responsible for the development of PTU-induced interstitial pneumonia (IP) is not clear. A number of adverse effects of PTU have been reported, including fever, agranulocytosis, and skin rash. Among pulmonary complications,

References (7)

There are more references available in the full text version of this article.

Cited by (15)

  • Pulmonary Complications of Endocrine Diseases

    2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth Edition
  • Thyroid hormones, iodine and iodides, and antithyroid drugs

    2014, Side Effects of Drugs Annual
    Citation Excerpt :

    The excess risk of leukemia was significantly greater in patients aged under 45 years (SIR = 5.3; 95% CI, 2.8, 9.3) compared with the excess risk in older patients (SIR = 2.3; 95% CI = 1.4, 3.4). Respiratory A 62-year-old woman took propylthiouracil for 1 year and developed a non-specific interstitial pneumonitis, with dyspnea, cough, a mild fever, and multifocal patchy consolidation in both lungs; the symptoms and abnormalities in the chest x-ray improved after withdrawal of propylthiouracil [71A]. Hematologic In a 24-year-old man and a 35-year-old woman, anemia with the features of iron deficiency, for which no other cause could be found, and which was resistant to treatment with iron, resolved when thiamazole was withdrawn [72A].

  • Pulmonary Complications of Vasculitis

    2021, Vasculitis: From Diagnosis to Treatment
  • Drug-induced vasculitis

    2019, Indian Journal of Rheumatology
View all citing articles on Scopus

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

View full text