CAJ | 학술논문

1例22岁女性患者因甲状腺功能亢进症服用丙硫氧嘧啶（50 mg，2次／d），6个月后出现咳嗽、咯血。胸部CT示双肺多发斑片状病变。支气管镜肺泡灌洗液检查显示灌洗液呈血性，诊断为弥漫性肺泡出血综合征。入院第9天，血清髓过氧化物酶-抗中性粒细胞胞质抗体检测呈阳性。考虑为丙硫氧嘧啶诱发的抗中性粒细胞胞质抗体相关性血管炎。以甲巯咪唑取代丙硫氧嘧啶，并应用甲泼尼龙。5d后，患者咯血停止；8d后，肺部病变明显改善。随访1年，患者未再出现咯血。
1례22세녀성환자인갑상선공능항진증복용병류양밀정（50 mg，2차／d），6개월후출현해수、각혈。흉부CT시쌍폐다발반편상병변。지기관경폐포관세액검사현시관세액정혈성，진단위미만성폐포출혈종합정。입원제9천，혈청수과양화물매-항중성립세포포질항체검측정양성。고필위병류양밀정유발적항중성립세포포질항체상관성혈관염。이갑구미서취대병류양밀정，병응용갑발니룡。5d후，환자각혈정지；8d후，폐부병변명현개선。수방1년，환자미재출현각혈。
A 22-year-old female patient with hyperthyroidism received propylthiouracil 50 mg twice daily. After 6 months,she presented cough,hemoptysis,a chest CT scan revealed multiple patchy opacities in both lungs. Bronchoalveolar lavage fluid showed bloody pulmonary alveolus. Diffuse alveolar hemorrhage syndrome was diagnosed. On hospital day 9,the biochemical studies indicated serological positive findings for myeloperoxidase-anti-neutrophil cytoplasmic antibody. Propylthiouracil-induced antineutrophil cytoplasmic antibody-associated vasculitis was considered. Propylthiouracil was switched to methimazole, and methylprednisolone was given. After 5 days,the hemoptysis stopped. After 8 days,her lung lesions improved significantly. During one-year follow-up,she had no hemoptysis.