Itoh H, Nakamura K, Nakashima A, Ohsato K, Tokikuni N, Kitajima C, Koni-i I, Tohfuku Y
Department of Internal Medicine, Wajima Hospital, Japan.
Intern Med. 1992 May;31(5):636-40. doi: 10.2169/internalmedicine.31.636.
A 76-year-old man with membranoproliferative glomerulonephritis complicated by methyldopa-induced colitis is reported. Eight months after administration of methyldopa, mucous bloody stool was noted. A barium enema examination showed disappearance of haustra and a spastic rectosigmoid with pseudo-polyposis. Biopsy specimens obtained from the sigmoid mucosa revealed interstitial edema and small inflammatory cells. After cessation of methyldopa treatment, the sigmoid findings, blood pressure, and proteinuria were improved, suggesting that methyldopa not only induced the acute colitis but also worsened the nephrotic syndrome in this patient.
报告了一名76岁男性,患有膜增生性肾小球肾炎,并伴有甲基多巴诱发的结肠炎。服用甲基多巴8个月后,出现黏液血便。钡剂灌肠检查显示结肠袋消失,直肠乙状结肠痉挛伴假息肉形成。从乙状结肠黏膜获取的活检标本显示间质水肿和少量炎性细胞。停用甲基多巴治疗后,乙状结肠病变、血压和蛋白尿均有改善,提示甲基多巴不仅诱发了该患者的急性结肠炎,还加重了肾病综合征。