塞尔科利祖马布诱导的肝损伤:根据更新的RUCAM评估因果关系
Muna Shakhashiro1, Rachel Crasta2, Faiza Javed3
1Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
BMJ case reports
|September 25, 2023
概括
一种生物药物塞尔科利祖马布 ( Certolizumab) 可能在风湿性关节炎患者中引起肝损伤. 停止使用克尔科利祖马布改善了肝酶,这表明药物诱导的肝毒性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
背景情况:
- 药物诱导性肝损伤 (DILI) 是一个重要的临床问题.
- 生物疗法,包括certol,越来越多地用于诸如类风湿性关节炎等自身免疫性疾病.
- 在DILI中确定致病因子对于患者管理至关重要.
研究的目的:
- 报告一种可能的药物诱导性肝损伤 (DILI) 病例,该病例是由于使用克罗利祖马布而导致的.
- 要突出诊断方法和因果关系评估在患有类风湿性关节炎的患者.
主要方法:
- 一个女性患者的病例介绍,患有类风湿性关节炎,高血压和2型糖尿病.
- 临床评估,包括肝酶的实验室评估.
- 使用罗塞尔·乌克拉夫因果关系评估方法 (RUCAM) 的因果关系评估.
主要成果:
- 患者出现了表胃疼痛和肝酶升高,表明肝细胞损伤.
- 停止使用certollizumab导致肝酶的改善.
- 鲁卡姆评分表明,克尔科利祖马布和肝损伤之间可能存在因果关系 (评分为7).
- 重新启动甲托雷克萨特并没有导致肝酶升高.
结论:
- 塞尔科利祖马布应被认为是风湿性关节炎患者肝细胞损伤的潜在原因.
- 迅速识别和停止违规药物是管理DILI的关键.
- 在疑似药物诱导的肝损伤中,RUCAM是评估因果关系的宝贵工具.
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