Severe skin eruptions and acute kidney injury during propylthiouracil treatment: A case report with review of literature

A 71-year-old female with Graves’ disease treated with propylthiouracil (PTU) developed severe skin eruptions with itching. About a month after PTU administration, drug eruptions appeared, and PTU was discontinued after 51 days of administration. Two days later, her creatinine level rose to 6.69 mg/dl, and she was diagnosed with acute kidney injury. Prednisolone therapy and emergency dialysis improved her renal function, and 81 days after discontinuation of PTU, her creatinine level improved to 1.26 mg/dl. We should promptly discontinue PTU in case of drug eruptions and be cautious of acute kidney injury, as reports have indicated PTU-induced drug eruptions and acute kidney injury due to acute interstitial nephritis not associated with anti-neutrophil cytoplasmic antibody. In cases of renal dysfunction, steroid therapy following renal biopsy should be considered. • Acute renal failure due to ANCA-negative acute interstitial nephritis may occur with drug eruptions after PTU administration. • PTU discontinuation and prompt assessment of renal function are necessary in cases of drug eruptions with eosinophilia after PTU administration. • Renal biopsy and steroid therapy should be considered in case of acute kidney injury after PTU administration.