Acute pancreatitis due to azathioprine in a patient with ulcerative colitis
10.3760/cma.j.cn114015-20220725-00673
- VernacularTitle:硫唑嘌呤致溃疡性结肠炎患者急性胰腺炎
- Author:
Yeqing CHEN
1
;
Hongyu ZHOU
1
;
Shuai YUAN
1
;
Zhenxiang WANG
1
Author Information
1. 解放军联勤保障部队第九二二医院消化内科，衡阳 421002
- Publication Type:Journal Article
- Keywords:
Colitis, ulcerative;
Azathioprine;
Acute pancreatitis
- From:
Adverse Drug Reactions Journal
2023;25(8):506-507
- CountryChina
- Language:Chinese
-
Abstract:
A 29-year-old male patient was treated with levofloxacin and other treatments for ulcerative colitis. Due to poor curative effect, he was given infliximab 300 mg intravenously, and his condition was stable after 3 times of medication. One month later, the patient developed mucinous bloody stool again, and enteroscopy showed ulcerative colitis (active phase). The patient received infliximab 300 mg intravenously once every 8 weeks and azathioprine 50 mg once daily orally. After 23 days of treatment, the patient developed persistent pain in the upper abdomen, serum amylase was 411 U/L, blood lipase was 1 415 U/L, and serum pancreatic amylase was 374 U/L. Abdominal CT showed acute pancreatitis, which was considered to be related to azathioprine. Seven days after discontinuation of azathioprine and treatment with fasting, acid suppression, anti-infection, and pancreatic secretion inhibition, his symptoms were relieved, and serum amylase and lipase levels returned to normal. One month later, the patient took azathioprine orally again according to the original dose by himself, and the symptoms of acute pancreatitis reappeared 6 hours later. The drug was stopped and the above treatments were given. Five days later, the patient′s symptoms were relieved, and the blood routine examination and serum amylase returned to normal.
