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Acute Pancreatitis Induced by Azathioprine and 6-mercaptopurine Proven by Single and Low Dose Challenge Testing in a Child with Crohn Disease

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주제분류소아과학

초록

We report here a case of drug-induced acute pancreatitis proved by elimination and single, low dose challenge test in a child with Crohn disease. A 14-year-old boy with moderate/severe Crohn disease was admitted due to high fever and severe epigastric pain during administration of mesalazine and azathioprine. Blood test and abdominal ultrasonography revealed acute pancreatitis. After discontinuance of the medication and supportive care, the symptoms and laboratory findings improved. A single, low dose challenge test was done to confirm the relationship of the adverse drug reaction and acute pancreatitis, and to discriminate the responsible drug. Azathioprine and 6-mercaptopurine showed positive responses, and mesalazine showed a negative response. We introduce the method of single, low dose challenge test and its interpretation for drug-induced pancreatitis.

Abstract

We report here a case of drug-induced acute pancreatitis proved by elimination and single, low dose challenge test in a child with Crohn disease. A 14-year-old boy with moderate/severe Crohn disease was admitted due to high fever and severe epigastric pain during administration of mesalazine and azathioprine. Blood test and abdominal ultrasonography revealed acute pancreatitis. After discontinuance of the medication and supportive care, the symptoms and laboratory findings improved. A single, low dose challenge test was done to confirm the relationship of the adverse drug reaction and acute pancreatitis, and to discriminate the responsible drug. Azathioprine and 6-mercaptopurine showed positive responses, and mesalazine showed a negative response. We introduce the method of single, low dose challenge test and its interpretation for drug-induced pancreatitis.

참고문헌 (14)

  1. 손창남, "다양한 약제에 의해 급성 췌장염이 발생한 궤양성 대장염 환자 1예", 대한소화기학회지, 52(3), pp.192~195 (2008), 대한소화기학회
  2. Lhee HY, "궤양성 대장염 환자에서 5-Aminosalicylic Acid로 유발된 급성 췌장염", 대한소화기학회지, 40(4), pp.282~285 (2002), 대한소화기학회
  3. 김국현, "5-aminosalicylic Acid 좌약에 의해 급성 췌장염이 유발된 궤양성 대장염 환자 1예", 대한소화기학회지, 50(6), pp.379~383 (2007), 대한소화기학회
  4. Trivedi CD, "Drug-induced pancreatitis: an update", J Clin Gastroenterol, 39, pp.709~716 (2005)
  5. Rasmussen HH, "Risk of acute pancreatitis in patients with chronic inflammatory bowel disease. A Danish 16-year nationwide follow-up study", Scand J Gastroenterol, 34, pp.199~201 (1999)
  6. Moolsintong P, "Acute pancreatitis in patients with Crohn's disease: clinical features and outcomes", Inflamm Bowel Dis, 11, pp.1080~1084 (2005)
  7. 최인영, "자가면역성 만성 췌장염으로 진단된 소아 1예", Pediatric Gastroenterology, Hepatology & Nutrition, 10(2), pp.215~220 (2007), 대한소아소화기영양학회
  8. 박찬복, "크론병 환자에서의 특발성 췌장염 1예", 대한소화기학회지, 53(4), pp.251~256 (2009), 대한소화기학회
  9. Bermejo F, "Acute pancreatitis in inflammatory bowel disease, with special reference to azathioprine-induced pancreatitis", Aliment Pharmacol Ther, 28, pp.623~628 (2008)
  10. Sturdevant RA, "Azathioprine-related pancreatitis in patients with Crohn's disease", Gastroenterology, 77, pp.883~886 (1979)
  11. Herrlinger KR, "The pancreas and inflammatory bowel diseases", Int J Pancreatol, 27, pp.171~179 (2000)
  12. Inoue H, "Acute pancreatitis in patients with ulcerative colitis", Dig Dis Sci, 50, pp.1064~1067 (2005)
  13. Alexander S, "Azathioprine pancreatitis in inflammatory bowel disease and successful subsequent treatment with mercaptopurine", Intern Med J, 35, pp.570~571 (2005)
  14. Nitsche CJ, "Drug induced pancreatitis", Best Pract Res Clin Gastroenterol, 24, pp.143~155 (2010)

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