Propylthiouracil (PTU)在甲狀腺亢進治療是否應該退居二線？

Should Propylthiouracil (PTU) be Used as Second Line Drug for Hyperthyroidism?

10.6314/JIMT.2011.22(4).02

蔡涵凱(Han-Kai Tsai)；魏淑儀(Shu-Yi Wei)；林興中(Hing-Chung Lam)

嗜中性白血球細胞質抗體陽性血管炎 ； 甲狀腺亢進治療藥物 ； Antineutrophil cytoplasmic antibody ANCA-positive vasculitis ； Propylthiouracil PTU

內科學誌

22卷4期（2011 / 08 / 01）

238 - 242

繁體中文

甲狀腺亢進治療藥物Propylthiouracil (PTU)是治療上常用的處方，在2009年因爲美國食品藥物管理局發表一篇警告，提醒臨床醫師注意可能之急性肝炎風險，應該避免第一線使用，但是一直很少有研究討論除了顆粒性白血球缺乏症(agranulocytosis)與急性肝炎之外，嗜中性白血球細胞質抗體陽性血管炎(antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis)也是一種嚴重的副作用。本文就近期的研究論文與治療指引，作一個重點式的文獻回顧。

Propylthiouracil (PTU) is a common medication to treat hyperthyroidism. The U.S. Food and Drug Administration (FDA) has added a boxed warning to labeling about the increased risk of hepatic failure with the use of propylthiouracil in June, 2009. However, there are few papers to discuss other adverse effects of PTU, other than agranulocytosis and acute hepatic failure, such as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. Here we review the literature of PTU-related ANCA-positive vasculitis and related adverse complication.