Vázquez Fuertes L, Martínez-Cócera C, Robledo Echarren T, Domínguez Ortega J, González Gutiérrez M L
Servicio de Alergia, Hospital Clínico San Carlos, Madrid.
An Med Interna. 2005 Dec;22(12):586-8. doi: 10.4321/s0212-71992005001200006.
Mesalazine is a derivative of 5-aminosalicylic acid (5-ASA), which is useful in the treatment of intestinal inflammatory disease. Sulfasalazine is formed by two parts, sulfapyridine and 5-ASA, the latter being the active part of the molecule. The new preparatives derived from 5-ASA were developed in an attempt to avoid the traditionally associated side effects to sulfapyridine, although they are still observed and new effects appear. We present two cases. The first is a man diagnosed of inflammatory intestinal disease, with background of two previous reactions of urticaria and angioedema after acetyl salicylic acid, who presented urticaria after taking mesalazine. The second one had generalized urticaria after three months of initiating treatment with mesalazine. Given the need for treatment in both cases, a desensitization protocol to mesalazine was made. It was developed in 17 days in our service. Tolerance to that drug to therapeutic doses is reached. When faced with patients with hypersensitivity to different drugs, that are necessary to treat their disease, "desensitization" regimes, that assure good tolerance, can be made.
美沙拉嗪是5-氨基水杨酸(5-ASA)的衍生物,可用于治疗肠道炎症性疾病。柳氮磺胺吡啶由两部分组成,即磺胺吡啶和5-ASA,后者是分子的活性部分。尽管仍会观察到与磺胺吡啶相关的传统副作用且出现了新的副作用,但人们研发了源自5-ASA的新型制剂,以试图避免这些副作用。我们介绍两例病例。第一例是一名被诊断为肠道炎症性疾病的男性,有两次服用乙酰水杨酸后出现荨麻疹和血管性水肿的病史,他在服用美沙拉嗪后出现了荨麻疹。第二例在开始使用美沙拉嗪治疗三个月后出现全身性荨麻疹。鉴于两例患者都需要进行治疗,因此制定了美沙拉嗪脱敏方案。该方案在我们科室用17天制定完成。患者对该药物的治疗剂量达到了耐受。当面对对不同药物过敏但又需要治疗其疾病的患者时,可以制定能确保良好耐受性的“脱敏”方案。