Turunen U, Elomaa I, Anttila V J, Seppälä K
Second Dept. of Internal Medicine, University Central Hospital, Helsinki, Finland.
Scand J Gastroenterol. 1987 Sep;22(7):798-802. doi: 10.3109/00365528708991917.
Fifty patients intolerant of or allergic to sulphasalazine (SASP) or sulphonamides were treated with mesalazine. Eighty per cent of patients continued treatment during the time of follow-up (mean, 8.4 months); 14% (7 of 50 patients) had to stop the treatment with mesalazine because of side effects. The patients with allergic reactions, including rash, fever, and systemic manifestations from SASP, were most likely to be intolerant of or allergic to mesalazine (four of seven patients); two of them developed a similar reaction from both SASP and mesalazine. Two patients (2 of 12) with previous haematologic side effects had to discontinue mesalazine treatment, one because of mild neutropaenia and one because of an elevation of liver enzyme values. One patient experienced gastrointestinal side effects from both mesalazine and SASP. Altogether, 4 (4 of 50) patients experienced gastrointestinal symptoms from mesalazine. Two of them had had a flare-up of the symptoms of the colitis when treated with SASP. All side effects were rapidly reversible after withdrawal of the drug. Patients with severe allergic reactions with systemic manifestations from SASP should be treated with caution with 5-aminosalicylic acid preparations.
五十名对柳氮磺胺吡啶（SASP）或磺胺类药物不耐受或过敏的患者接受了美沙拉嗪治疗。80%的患者在随访期间（平均8.4个月）持续接受治疗；14%（50名患者中的7名）因副作用不得不停止美沙拉嗪治疗。有过敏反应（包括皮疹、发热和SASP引起的全身表现）的患者最有可能对美沙拉嗪不耐受或过敏（7名患者中的4名）；其中两名患者对SASP和美沙拉嗪均出现了类似反应。两名曾有血液学副作用的患者（12名中的2名）不得不停止美沙拉嗪治疗，一名是因为轻度中性粒细胞减少，另一名是因为肝酶值升高。一名患者对美沙拉嗪和SASP均出现胃肠道副作用。总共有4名（50名中的4名）患者出现了美沙拉嗪引起的胃肠道症状。其中两名患者在用SASP治疗时结肠炎症状曾复发。停药后所有副作用均可迅速逆转。有SASP引起的严重全身过敏反应的患者应谨慎使用5-氨基水杨酸制剂。
