与红酵母大米有关的药物诱导的肝损伤
María Desirée García-García1, Francisco Bellido Muñoz2, Patricia Cordero Ruiz3
1Aparato Digestivo, Hospital Universitario Virgen Macarena, España.
Revista espanola de enfermedades digestivas
|July 14, 2023
概括
红酵米 (RYR) 可以引起药物诱导性肝损伤 (DILI),呈现为急性肝炎. 停止RYR导致症状消失,突出其潜在的肝毒性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 毒理学 毒理学 毒理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肝毒性或肝损伤可能是药物,草药或食补充剂造成的.
- 红酵母大米 (RYR),含有莫纳科林K (化学上与洛瓦斯塔丁相同),用于治疗高脂血症.
- 报告了少数与RYR相关的肝炎病例,可能是由于有毒或免疫原代谢物引起的.
研究的目的:
- 报告可能由红酵母大米 (RYR) 消费引起的急性肝炎病例.
- 讨论RYR.R.引起的药物诱导性肝损伤 (DILI) 的诊断挑战和管理.
- 突出RYR引起肝毒性的潜力,即使具有积极的自身免疫标志物.
主要方法:
- 一个62岁妇女的案例研究,呈现急性肝炎的症状.
- 临床评估包括评估症状,药物史 (RYR使用) 和实验室测试.
- 混合肝细胞和胆固醇性急性肝炎的诊断得到证实;药物诱导性肝损伤相互分类 (DILI-RC) 评分被计算.
主要成果:
- 在开始RYR后,患者发烧,尿液变黑,体重减轻.
- 诊断为混合肝细胞和胆固醇性急性肝炎,DILI的概率很高 (DILI总RECAM分数 = 8).
- 在RYR排除后,患者的肝酶和胆红素水平逐渐下降.
结论:
- 红酵米 (RYR) 可以诱导急性肝炎,一种药物诱导性肝损伤 (DILI) 的形式.
- 由于交叉反应,可以发生积极的自身免疫血清学,但不应排除RYR的肝毒性.
- 保守的管理,包括停止RYR,是有效的解决RYR诱导的肝损伤.
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