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Persistent Müllerian duct syndrome (PMDS) is a rare autosomal recessive syndrome characterized by the coexistence of Müllerian derivatives in a normally virilized male, caused by mutations in the AMH or AMHR2 gene. This paper reports the case of a 33-year-old man with PMDS, diagnosed late during an infertility check-up. Exploratory laparoscopy revealed two intra-pelvic gonads and Müllerian duct structures. Genetic analysis identified an undescribed homozygous missense mutation in the fifth exon of AMH. Typically, PMDS is diagnosed in the presence of cryptorchidism or inguinal hernia, and rarely in the context of infertility. Early orchidopexy is recommended to mitigate fertility sequelae while preserving endogenous hormone secretion. This late diagnosis of PMDS led to a discussion of the management of infertility, surgical strategies and adult follow-up. In this case, the decision was made with the patient to perform minimally invasive surgery, specifically unilateral orchidectomy for fertility management. The biopsy revealed no spermatozoa, probably due to prolonged untreated pelvic cryptorchidism. Retaining one testicle maintains endogenous testosterone production, thus avoiding imperfect hormonal replacement. Given the risk of tumoural degeneration, albeit a low one, annual imaging follow-up is mandatory and removal of Müllerian structures and gonadectomy may be considered if necessary., (Copyright © 2024 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Introduction: Propylthiouracil (PTU) is a synthetic antithyroid drug that can induce ANCA-associated vasculitis., Observation: A 27-year-old woman diagnosed with Graves' disease was on PTU for the past 10 years. She developed purpuric lesions of the legs and on the tip of the nose diagnosed as vasculitis. ANCAs were positive, with anti-MPO and anti-PR3 on blood ELISA. After discontinuation of PTU, she was able to fully recover., Conclusion: All synthetic antithyroid drugs can induce ANCA-associated vasculitis, more often PTU. In most cases, antibodies are directed against MPO. Dual anti-MPO and anti-PR3 positivity is possible, but rare. The mechanism could be through an accumulation of PTU in neutrophils, altering the structure of MPO and making it immunogenic. PTU can also induce ANCA-free or lupus vasculitis, maculopapular rashes or urticaria. Many other drugs can induce ANCA-associated vasculitis., (Copyright © 2021 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)