Serial measurements of sFlt-1/PlGF ratio suggested pre-eclampsia was unlikely. We compared the results to post partum specimens collected from previous women with varying HDP. The events would be consistent with PRES due to cerebral traction trauma secondary to spinal fluid leak. Conclusions: This case report highlights the utility of measuring circulating angiogenic markers in clarifying the cause of post partum seizures. This is the first case where post partum PRES secondary to epidural anaesthesia has been

described with the use of sFlt-1/PlGF to help reach the diagnosis. 300 PROPYLTHIOURACIL see more INDUCED ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) VASCULITIS V LIM, A DAVID, S TOOMBES, S VENUTHURUPALLI Renal Medicine, Toowoomba Hospital, Toowoomba, Queensland, Australia Aim: To present a case of Propylthiouracil induced anti-neutrophil cytoplasmic antibody vasculitis (AAV). Background: Propylthiouracil (PTU) is commonly used to treat hyperthyroidism. PTU is known to be associated with AAV. PTU induced vasculitis differs from primary AAV as being common in younger

patients with a milder course although fatal cases were described especially when diagnosis was delayed. Case Report: A 58 year old lady presented with one month history of haematuria, increasing polyarthralgia on a background of rheumatoid arthritis X-396 purchase for six years. She noticed progressive dyspnoea for the last eighteen months and skin lesions over three years. She was

diagnosed to have multinodular goitre with thyrotoxicosis in 2006. She was initially treated with Carbimazole but changed to PTU due to nausea since 2010. Her thyrotoxicosis was controlled successfully with PTU. She had normal renal functions during these years. Initial investigations revealed elevated serum creatinine Tau-protein kinase with proteinuria and haematuria, microcytic anaemia and raised inflammatory markers. She tested positive for both PR3 and MPO ANCAs, anti-nuclear antibody and anti-cyclic citrulline peptide antibody. High resolution computed tomography showed ground glass opacities in lungs fields. With her clinical presentation and investigations, PTU induced AAV involving skin, lungs and kidney was considered. PTU was ceased and she was commenced on Prednisolone and Cyclophosphamide. Kidney biopsy revealed features of acute tubular injury with red cell casts and minimal immunofluorescent reactivity for IgG and C3. There were no crescents or necrotising lesions. Electron microscopy is pending. Her renal function was stabilised following treatment with improvement of respiratory and cutaneous symptoms. Conclusions: ANCA-positive multisystem involvement can be observed following treatment of PTU and requires a high index of suspicion for early detection and treatment.