对柳氮磺吡啶过敏后出现对美沙拉嗪的过敏反应并伴有肝毒性。

Hypersensitivity with hepatotoxicity to mesalazine after hypersensitivity to sulfasalazine.

作者信息

Hautekeete M L, Bourgeois N, Potvin P, Duville L, Reynaert H, Devis G, Adler M, Klöppel G

机构信息

Department of Hepatogastroenterology, Free University of Brussels (Academic Hospital-VUB and Hôpital Erasme-ULB), Belgium.

出版信息

Gastroenterology. 1992 Dec;103(6):1925-7. doi: 10.1016/0016-5085(92)91453-b.

DOI:10.1016/0016-5085(92)91453-b

PMID:1360436

Abstract

A 21-year-old woman with Crohn's disease of the colon developed a skin rash after 3 weeks of treatment with sulfasalazine. Administration of sulfasalazine was discontinued. When mesalazine was instituted 1 week later, she developed a severe hypersensitivity reaction characterized by fever, diarrhea, skin rash with subsequent desquamation, marked atypical lymphocytosis, and severe hepatotoxicity. Recovery was complete. The clinical and biological features as well as liver pathology of this case bear a striking resemblance to earlier reports of hypersensitivity reaction with severe hepatotoxicity to sulfasalazine. The authors urge caution when mesalazine is given to a patient with known hypersensitivity to sulfasalazine.

摘要

一名患有结肠克罗恩病的21岁女性在接受柳氮磺胺吡啶治疗3周后出现皮疹。停用柳氮磺胺吡啶。1周后开始使用美沙拉嗪时，她出现了严重的过敏反应，表现为发热、腹泻、皮疹伴随后的脱屑、明显的非典型淋巴细胞增多和严重的肝毒性。最终完全康复。该病例的临床和生物学特征以及肝脏病理与早期关于对柳氮磺胺吡啶严重肝毒性过敏反应的报道极为相似。作者敦促，当给已知对柳氮磺胺吡啶过敏的患者使用美沙拉嗪时要谨慎。