吗替麦考酚酯致婴儿肝移植术后结肠炎  

Mycophenolate mofetil‑induced colitis after liver transplantation in an infant

作　　者：官晓艳[1] 陈章 宁俊杰 Guan Xiaoyan;Chen Zhang;Ning Junjie(Department of Pediatrics,the First People′s Hospital of Zigong City,Sichuan Province,Zigong 643000,China;Department of Pediatrics,Maternal and Child Health Hospital of Fushun County of Zigong City,Sichuan Province,Zigong 643200,China)

机构地区：[1]四川省自贡市第一人民医院儿科,自贡643000 [2]四川省自贡市富顺县妇幼保健院儿科,自贡643200

出　　处：《药物不良反应杂志》2022年第6期322-324,共3页Adverse Drug Reactions Journal

摘　　要：1例11个月女婴4月龄时因先天性胆道闭锁行肝移植术,术后给予吗替麦考酚酯(MMF)联合他克莫司口服治疗。用药6个月后患儿出现顽固性腹泻,予以止泻、肠外肠内营养支持等治疗无效。实验室检查:粪便沙门氏菌、志贺氏菌、弯曲杆菌、艰难梭菌、耶尔森氏菌、产肠毒素大肠杆菌、寄生虫均阴性;血浆巨细胞病毒DNA阴性。他克莫司血药浓度为9.3μg/L。结肠镜及病理学检查示炎症性肠病特征。考虑患儿可能为MMF所致结肠炎。停用该药,其他治疗不变,1周后患儿腹泻停止。1个月后随访,患儿未再出现腹泻。An 11⁃month⁃old female infant underwent liver transplantation due to congenital biliary atresia at the age of 4 months.She was treated with mycophenolate mofetil(MFF)combined with tacrolimus orally after the operation.Six months after the medication,the infant developed intractable diarrhea,which was not improved after the treatment of diarrhea cessation,parenteral and enteral nutrition supports.Laboratory tests showed that stool tests were negative for Salmonella,Shigella,Campylobacter,Clostridium difficile,Yersinia,Enterotoxigenic Escherichia coli,and parasites;plasma cytomegalovirus DNA was negative.Serum concentration of tacrolimus was 9.3 mg/L.Colonoscopy and pathological examination showed characteristics of inflammatory bowel disease.Colitis caused by MMF was considered.Then MMF was discontinued and other treatments were continued.One week after the drug discontinuation,diarrhea stopped in the infant.At 1 month follow⁃up,diarrhea did not recur.

关 键 词：霉酚酸 婴儿 肝移植 结肠炎 

分 类 号：R969[医药卫生—药理学]