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The triggers that induce antineutrophil cytoplasmic antibody (ANCA)–positive vasculitis (APV) are largely unknown. However, there have been reports suggesting that hydralazine, propylthiouracil, and several other drugs may cause some cases of APV, and the majority of these cases have been associated with antimyeloperoxidase (anti‐MPO) ANCA. Our experience led us to hypothesize that cases of high titers of anti‐MPO antibodies are often drug‐associated.

In this study, we determined the prevalence of exposure to hydralazine, propylthiouracil, and other drugs previously implicated in APV among 30 patients with vasculitis and the highest titers of anti‐MPO antibodies newly detected in our laboratory between 1994 and 1998. The clinical, histologic, and other serologic features of these 30 patients were also examined.

The 30 study patients accounted for 12% of the 250 new …