Jayaraman Thevaraajan, Rajaram Ruveena Bhavani, Gan Gin Gin, Hilmi Ida
Gastroenterology Unit, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Intest Res. 2021 Oct;19(4):468-471. doi: 10.5217/ir.2020.00099. Epub 2020 Dec 1.
Hydroxyurea is an antimetabolite drug that is commonly used in many hematological disorders. Ulcer formation in the gastrointestinal tract is a rare phenomenon associated with this drug. We report a case of a 73-year-old woman who was found to have an isolated ileocecal valve ulcer while on hydroxyurea 1 g daily for essential thrombocythemia. A comprehensive evaluation ruled out all other causes. The cytoreductive therapy was switched to anagrelide and the endoscopic evaluation 6 months later showed complete healing of the ulcer. However, the hydroxyurea was resumed due to increasing platelet counts and intolerance to dose increments of the anagrelide. Subsequently, the patient was found to have a recurrence of the ulcer. Apart from oral ulcers, there have also been reports of ulcers involving the small bowel and the colon associated with the use of hydroxyurea. The pathophysiology of the non-oral gastrointestinal ulceration in relation to this drug is unclear. Withdrawal of the drug typically leads to complete resolution. Increasing awareness of the rare association between the use of hydroxyurea and nonoral gastrointestinal ulcers is essential for early detection to prevent related complications.
羟基脲是一种抗代谢药物，常用于多种血液系统疾病。胃肠道溃疡形成是与该药物相关的罕见现象。我们报告一例73岁女性病例，该患者因原发性血小板增多症每日服用1克羟基脲时，被发现有孤立的回盲瓣溃疡。全面评估排除了所有其他病因。细胞减灭治疗改为阿那格雷，6个月后的内镜评估显示溃疡完全愈合。然而，由于血小板计数增加以及对阿那格雷剂量增加不耐受，羟基脲又重新开始使用。随后，发现该患者溃疡复发。除口腔溃疡外，也有报道称使用羟基脲会导致小肠和结肠溃疡。与该药物相关的非口腔胃肠道溃疡的病理生理学尚不清楚。停药通常会使溃疡完全消退。提高对使用羟基脲与非口腔胃肠道溃疡之间罕见关联的认识，对于早期发现以预防相关并发症至关重要。
