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1例28岁女性患者,因垂体炎所致中枢性尿崩症给予甲泼尼龙40 mg、1次/d静脉注射。2周后改为泼尼松10 mg、3次/d口服,硫唑嘌呤50 mg、2次/d口服。第4天,患者出现上腹胀、反酸、恶心。给予对症治疗,效果不佳。1周后停用泼尼松。2周后患者出现剧烈上腹痛伴呕吐。胃镜检查示慢性胃炎。遂停用硫唑嘌呤。2 d后胃肠道症状明显缓解。1周后胃肠道症状消失,但尿量逐渐增多,再次给予硫唑嘌呤50 mg口服。服药后约1 h,再次出现相同胃肠道症状,对症治疗后缓解。
A 28-year-old female patient with central diabetes insipidus due to hypophysitis was given methylprednisolone 40 mg once daily by intravenous injection. 2 weeks later changed to prednisone 10 mg, 3 times / d orally, azathioprine 50 mg, 2 times / d orally. On day 4, the patient developed abdominal distension, acid reflux, and nausea. Give symptomatic treatment, the effect is not good. Suspension of prednisone after 1 week. 2 weeks after the patient had severe abdominal pain with vomiting. Gastroscopy showed chronic gastritis. Then disable azathioprine. Gastrointestinal symptoms were relieved 2 days later. Gastrointestinal symptoms disappeared after 1 week, but the amount of urine gradually increased again given azathioprine 50 mg orally. About 1 h after taking the medicine, the same gastrointestinal symptoms appear again and the symptoms are relieved after symptomatic treatment.