Table 1.

Drugs commonly implicated in ANCA-associated vasculitis

DrugEvidenceRenal InvolvementComments
Cocaine and levamisoleMultiple case series and case reports44%aSkin manifestations in 61%a
Neutropenia in 28%a
HydralazineCase series and case reports80%–90%bCombined pulmonary-renal syndrome is rare (15 patients to date)
Lupus-like syndrome is common
Antithyroid medicationsPTU: multiple case series and case reportsMay be commonAnimal models also support association with PTU
Carbimazole and methimazole: case reports
MinocyclineSmall case series and case reportsNo reported cases of renal involvement with small-vessel vasculitisConflicting data on ANCA seroconversion with minocycline use (45,46)
PAN with p-ANCA positivity and renal involvement reported
AllopurinolCase reportsReportedPulmonary-renal syndrome rarely reported
PenicillamineCase reportsReportedNo seroconversion noted in analysis of scleroderma trial (46)
SulfasalazineCase reportsReportedPulmonary-renal syndrome also reported
No seroconversion noted in analysis of the CSSRD Trial (46)
  • PTU, propylthiouracil; PAN, polyarteritis nodosa; p-ANCA, perinuclear ANCA; CSSRD, Cooperative Systematic Studies of the Rheumatic Diseases.

  • a Data from the largest case series of cocaine- and levamisole-associated, ANCA-associated vasculitis (21).

  • b Data from the largest series of hydralazine-associated, ANCA-associated vasculitis (5,38).