National Capital Consortium-Dewitt Army Community Hospital, Family Medicine Residency, Ft. Belvoir, VA, USA.
J Am Board Fam Med. 2010 Jan-Feb;23(1):124-7. doi: 10.3122/jabfm.2010.01.090086.
Serotonin-1 5-hydroxytryptamine (5-HT 1) receptor agonists are first line agents for migraine headaches. Patients with refractory headaches may use supratherapeutic doses of these medications. Described is a case of ischemic colitis related to overuse of sumatriptan.
A 35-year-old woman presented with severe abdominal pain without diarrhea or hematochezia. For several days prior she had been self-treating a refractory migraine headache with frequent doses of sumatriptan. She is a nonsmoker and took no oral contraceptives or other serotonin agonists. A computed tomography scan of the abdomen revealed left-sided colitis. A colonoscopy with biopsy confirmed ischemic colitis and excluded inflammatory bowel disease (IBD).
Previously published case reports have suggested an association between 5-HT 1 receptor agonists and ischemic colitis. These reports have been dismissed because the patients were taking oral contraceptives, serotonin agonists, or had other comorbidities. This healthy patient lacked risk factors for ischemia, is the youngest to be reported, and is the first without hematochezia.
5-HT 1 receptor agonists are generally considered safe. Ischemic colitis is a potentially serious complication of these agents. A retrospective review of 5-HT 1 receptor agonist users who have presented with acute onset abdominal pain or hematochezia is necessary to elucidate the incidence of this adverse event.
5-羟色胺 1 受体激动剂（5-HT 1）是偏头痛的一线治疗药物。对于难治性头痛患者，可能会使用这些药物的超治疗剂量。本文描述了一例与舒马曲坦过度使用相关的缺血性结肠炎。
一名 35 岁女性因严重腹痛而就诊，无腹泻或血便。在发病前几天，她一直使用舒马曲坦频繁治疗难治性偏头痛。她不吸烟，也未服用口服避孕药或其他 5-HT 激动剂。腹部计算机断层扫描显示左侧结肠炎。结肠镜检查和活检证实为缺血性结肠炎，并排除了炎症性肠病（IBD）。
先前发表的病例报告表明 5-HT 1 受体激动剂与缺血性结肠炎之间存在关联。这些报告被驳回，因为患者正在服用口服避孕药、5-HT 激动剂或存在其他合并症。这位健康的患者没有缺血的风险因素，是报告中最年轻的，也是第一个没有血便的患者。
5-HT 1 受体激动剂通常被认为是安全的。缺血性结肠炎是这些药物的潜在严重并发症。有必要对出现急性腹痛或血便的 5-HT 1 受体激动剂使用者进行回顾性审查，以阐明这种不良事件的发生率。
