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1例溃疡性结肠炎患者对美沙拉嗪不耐受,在服用柳氮磺吡啶期间并发粒细胞缺乏症和感染性休克

[A case of ulcerative colitis with mesalazine intolerance complicated with agranulocytosis and septic shock during salazosulfapyridine administration].

作者信息

Ikehata Atsushi, Honta Shunsuke, Sekino Yasumasa, Masuo Takayuki, Eizuka Kei, Inomata Nana, Ono Sadahide

机构信息

Department of Gastroenterology, Iwate Prefectural Central Hospital.

Department of Endoscopy, Iwate Prefectural Central Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2023;120(9):764-772. doi: 10.11405/nisshoshi.120.764.

Abstract

A 73-year-old woman developed ulcerative colitis with mesalazine intolerance a year ago. She relapsed 10 months later. Although she was in clinical remission with salazosulfapyridine (SASP) and prednisolone administration, she developed agranulocytosis 53 days following SASP administration. She went into septic shock;however, she recovered with antibiotics, granulocyte colony-stimulating factor, and cardiotonic agents. Drug-induced lymphocyte stimulation test was positive for both mesalazine and SASP. Drug selection should be carefully determined in patients with 5-aminosalicylic acid intolerance.

摘要

一名73岁女性一年前患上溃疡性结肠炎且对美沙拉嗪不耐受。10个月后病情复发。尽管使用柳氮磺胺吡啶(SASP)和泼尼松龙治疗后她处于临床缓解期,但在服用SASP 53天后出现了粒细胞缺乏症。她陷入感染性休克;然而,通过使用抗生素、粒细胞集落刺激因子和强心剂后康复。药物诱导淋巴细胞刺激试验显示美沙拉嗪和SASP均呈阳性。对于5-氨基水杨酸不耐受的患者,应谨慎确定药物选择。

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