{Reference Type}: Multicenter Study
{Title}: Characteristics and outcome of ANCA-associated vasculitides induced by anti-thyroid drugs: a multicentre retrospective case-control study.
{Author}: Culerrier J;Nguyen Y;Karadag O;Yasar Bilge S;Yildrim TD;Ögüt TS;Yazisiz V;Bes C;Celfe A;Yazici A;Sadioglu Cagdas O;Kronbichler A;Jayne D;Gauckler P;Regent A;Teixeira V;Marchand-Adam S;Duffau P;Housz-Oro SI;Droumaguet C;Andre B;Luca L;Lechtman S;Aouba A;Lebas C;Servettaz A;Dernoncourt A;Ruivard M;Milesi AM;Poindron V;Jego P;Padoan R;Delvino P;Vandergheynst F;Pagnoux C;Yacyshyn E;Lamprecht P;Flossmann O;Puéchal X;Terrier B;
{Journal}: Rheumatology (Oxford)
{Volume}: 63
{Issue}: 4
{Year}: 2024 Apr 2
{Factor}: 7.046
{DOI}: 10.1093/rheumatology/kead319
{Abstract}: <B>OBJECTIVE: </B>Data on ANCA-associated vasculitis (AAV) induced by anti-thyroid drugs (ATD) are scarce. We aimed to describe the characteristics and outcome of these patients in comparison to primary AAV.<BR><B>METHODS: </B>We performed a retrospective multicentre study including patients with ATD-induced AAV. We focused on ATD-induced microscopic polyangiitis (MPA) and compared them with primary MPA by matching each case with four controls by gender and year of diagnosis.<BR><B>RESULTS: </B>Forty-five patients with ATD-induced AAV of whom 24 MPA were included. ANCA were positive in 44 patients (98%), including myeloperoxidase (MPO)-ANCA in 21 (47%), proteinase 3 (PR3)-ANCA in six (13%), and double positive MPO- and PR3-ANCA in 15 (33%). Main clinical manifestations were skin involvement (64%), arthralgia (51%) and glomerulonephritis (20%). ATD was discontinued in 98% of cases, allowing vasculitis remission in seven (16%). All the remaining patients achieved remission after glucocorticoids, in combination with rituximab in 11 (30%) or cyclophosphamide in four (11%). ATD were reintroduced in seven cases (16%) without any subsequent relapse. Compared with 96 matched primary MPA, ATD-induced MPA were younger at diagnosis (48 vs 65 years, P < 0.001), had more frequent cutaneous involvement (54 vs 25%, P = 0.007), but less frequent kidney (38 vs 73%, P = 0.02), and a lower risk of relapse (adjusted HR 0.07; 95% CI 0.01, 0.65, P = 0.019).<BR><B>CONCLUSIONS: </B>ATD-induced AAV were mainly MPA with MPO-ANCA, but double MPO- and PR3-ANCA positivity was frequent. The most common manifestations were skin and musculoskeletal manifestations. ATD-induced MPA were less severe and showed a lower risk of relapse than primary MPA.