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J Rheumatol. 2006 Mar;33(3):629-32. Epub 2006 Feb 15.

Pantoprazole and perinuclear antineutrophil cytoplasmic antibody-associated vasculitis.

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Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.


Systemic vasculitis may, at times, be drug-induced and associated with antineutrophil cytoplasmic antibodies (ANCA). However, pantoprazole, a commonly used and well-tolerated proton pump inhibitor, has not previously been reported to cause ANCA-associated syndromes. We describe a patient who developed interstitial nephritis, cutaneous vasculitis, a perinuclear ANCA staining pattern (pANCA) on immunofluorescence, and anti-myeloperoxidase antibodies (MPO-ANCA) in association with pantoprazole. We review various immune-mediated syndromes reported in association with proton pump inhibitors, including one report of omeprazole associated with interstitial nephritis and the development of ANCA.

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