Acute pancreatitis induced by oral azathioprine tablets in a myasthenia gravis patient
10.3760/cma.j.issn.1008-5734.2020.01.012
- VernacularTitle:口服硫唑嘌呤片致重症肌无力患者急性胰腺炎
- Author:
Dayong ZENG
1
;
Jiashan DONG
;
Pinfang HUANG
;
Changlian WANG
;
Rongfang LIN
Author Information
1. 福建医科大学附属第一医院药学部，福州 350005
- Publication Type:Journal Article
- Keywords:
Myasthenia gravis;
Azathioprine;
Pancreatitis
- From:
Adverse Drug Reactions Journal
2020;22(1):48-49
- CountryChina
- Language:Chinese
-
Abstract:
A 65-year-old male patient was treated with pyridostigmine bromide tablets (30 mg thrice daily), azathioprine tablets (75 mg twice daily), and prednisone acetate tablets (15 mg once daily) for myasthenia gravis. Two months later, the patient developed abdominal pain, nausea, and vomiting. The laboratory tests showed the blood lipase (LPS) 909 U/L and the urine amylase (AMS) 3 838 U/L. The results of abdominal ultrasonography and imaging examination were consistent with the manifestations of pancreatitis. Above-mentioned drugs were not stopped and the patient was treated according to the conventional treatment regimen of acute pancreatitis. However, the symptoms did not improved significantly. On the 11th day after the onset of the disease, he received subcutaneous infusion of octreotide injection, intravenous infusion of pantoprazole sodium for injection, oral metronidazole, and supportive treatments such as fluid supplement and correction of water electrolyte disorders. The laboratoty tests the next day showed that the patient′s blood LPS was 3 332 U/L and AMS was 139 U/L. The acute pancreatitis was considered to be related to azathioprine tablets. Then the drug was stopped and other treatments were continued. The patient′s symptoms improved quickly. Four days later, LPS was 546 U/L and AMS was 49 U/L.
