Propylthiouracil-related hemorrhagic diathesis: a case report and review of the literature

We present an unusual case of a drug-related hemorrhagic diathesis. One month prior to admission, the patient was diagnosed at another medical center as having Graves' disease and propylthiouracil therapy (PTU) was initiated. Since clinical recovery was not achieved, the PTU was quickly increased to an unconventional daily dose of 1,000 mg. The patient was referred to our hospital because of spontaneous epistaxis, multiple ecchymoses and prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), which developed soon after the increase in PTU dose. Drug-related hemorrhagic diathesis was considered, after other possible causes had been eliminated. To the best of our knowledge, this is the first reported case of spontaneous hemorrhage due to PTU use.