Cox J, Daneshmend T K, Hawkey C J, Logan R F, Walt R P
Department of Therapeutics, University Hospital Nottingham.
Gut. 1988 May;29(5):686-8. doi: 10.1136/gut.29.5.686.
Azathioprine toxicity complicated the management of four patients with inflammatory bowel disease. All patients received the drug as adjunctive therapy to steroids when responses to the latter were poor. After a variable sensitising period the patients developed severe diarrhoea and abdominal pain and this was believed at first to be a manifestation of their underlying diseases but rechallenge with azathioprine reproduced the problem. During three episodes described emergency admission to hospital and resuscitation with intravenous fluids was required. The cases illustrate the difficulty clinicians have in recognising drug induced effects which mimic the underlying disease. When a patient suspects a reaction to azathioprine we believe any rechallenge should only be undertaken in the controlled hospital environment.
硫唑嘌呤毒性使四名炎症性肠病患者的治疗变得复杂。所有患者在对类固醇反应不佳时，均接受该药物作为类固醇的辅助治疗。在一段长短不一的致敏期后，患者出现严重腹泻和腹痛，起初认为这是其基础疾病的表现，但再次使用硫唑嘌呤时问题再次出现。在所描述的三次发作期间，患者需要紧急入院并通过静脉输液进行复苏。这些病例说明了临床医生在识别模仿基础疾病的药物诱导效应方面存在的困难。当患者怀疑对硫唑嘌呤有反应时，我们认为任何再次用药都应仅在可控的医院环境中进行。
