Propylthiouracil-induced organizing pneumonia: A case report

Abstract

Rationale: Propylthiouracil (PTU) is a common antithyroid drug which can treat hyperthyroidism effectively. PTU is, however, associated to multiple adverse effects. In rare case, PTU can cause interstitial pneumonia.

Patient concerns: A 40-year-old woman presented with dyspnea and was diagnosed with pulmonary infection at the first time. After the treatment with moxifloxacin, her symptoms still got worse.

Diagnosis: The lung tissues biopsy confirmed the diagnosis of organizing pneumonia (OP) and the administration of PTU suggested the diagnosis of PTU-induced OP.

Intervention: Withdrawal of PTU and the administration of methylprednisolone.

Outcomes: The patient's symptoms relieved significantly 1 month later and lung computed tomography (CT) scan also demonstrated significant reduction of lung lesions.

Lessons: Here we report the first case of histologically confirmed OP induced by PTU and conduct a literature review of the cases of PTU-induced interstitial pneumonia. The awareness of PTU-induced OP can help physicians reduce the possibility of misdiagnosis.

Figure 1

A, A chest computed tomography (CT) scan in local hospital showed bilateral interstitial enlargement along the bronchovascular bundle. B, A chest CT scan in our hospital revealed the lung lesions were progressing with many new ground-glass lesions. C, The CT scan performed 1 month later showed the improvement of the lung lesions (C).

Figure 2

The pathological findings of lung tissues showed that there was obvious hyperplasia of the fibrous tissues alveolar septum (A) and hemorrhage in the pulmonary alveoli (B).