The Effect of Renal Replacement Therapy in a Patient with Mercaptopurine Toxicity: Time to Revise Guidelines.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
H J L Quaedvlieg, F N Polderman, M Borkent, De H J M Jonge, P A Annema, L J J Derijks, M A Sikma, C Bethlehem
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引用次数: 0

Abstract

Introduction: Mercaptopurine, a thiopurine, is used in various disorders of immune regulation, such as autoimmune hepatitis. Thiopurine metabolism is complex with risk for overdosing, especially when metabolism is impaired by liver dysfunction. Hepatotoxicity may be due to mercaptopurine overdose and is often reversible after prompt cessation of the drug.

Case presentation: Treatment of thiopurine toxicity is mainly supportive and literature on enhanced elimination by renal replacement therapy is ambiguous.

Conclusion: In this case of thiopurine toxicity, a patient with autoimmune hepatitis presents with abdominal pain, nausea, vomiting, and diarrhea. We show in this case report that renal replacement therapy had no effect on total body clearance of mercaptopurine.

肾脏替代疗法对巯嘌呤中毒患者的影响:是时候修订指南了
简介巯嘌呤是一种硫嘌呤类药物,用于治疗各种免疫调节紊乱,如自身免疫性肝炎。硫嘌呤代谢过程复杂,有用药过量的风险,尤其是当肝功能障碍导致代谢受损时。肝中毒可能是由于巯嘌呤用药过量所致,在及时停药后通常可以逆转:病例介绍:硫嘌呤中毒的治疗主要是支持性治疗,关于通过肾脏替代疗法提高排毒效果的文献不明确:在本例硫嘌呤中毒病例中,一名自身免疫性肝炎患者表现为腹痛、恶心、呕吐和腹泻。本病例报告显示,肾脏替代疗法对巯嘌呤的全身清除率没有影响。
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来源期刊
Current drug safety
Current drug safety PHARMACOLOGY & PHARMACY-
CiteScore
2.10
自引率
0.00%
发文量
112
期刊介绍: Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.
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