Cochrane P, Atkins P, Ehsanullah S
Postgrad Med J. 1973 Sep;49(575):669-72. doi: 10.1136/pgmj.49.575.669.
A case report of a patient with agranulocytosis associated with sulphasalazine therapy is described. Recovery followed supportive therapy and withdrawal of the drug. Investigations including tests for leucocyte antibodies, the presence of which might have suggested an immunological cause for the drug reaction, were negative; an acetylation study, however, characterized the patient as a ‘slow’ acetylator phenotype, suggesting that the drug reaction was more likely to have been toxic in nature. It is suggested that acetylation studies be performed in patients who have previously shown serious side effects to sulphasalazine to assess the incidence of ‘slow’ acetylators.
本文描述了1例与柳氮磺胺吡啶治疗相关的粒细胞缺乏症患者的病例报告。患者经支持治疗及停用该药物后康复。包括白细胞抗体检测在内的各项检查结果均为阴性，而白细胞抗体的存在可能提示药物反应存在免疫原因；然而，一项乙酰化研究显示该患者为“慢”乙酰化代谢型，这表明该药物反应更可能本质上是毒性反应。建议对既往使用柳氮磺胺吡啶出现严重副作用的患者进行乙酰化研究，以评估“慢”乙酰化代谢型的发生率。
