药物诱导的肝损伤是他莫西芬的次要原因
Deloshaan Subhaharan1, Grace Murphy2, Natalie Commins1
1Department of Hepatology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia natalie.commins@gmail.com deloshaan.subhaharan@health.qld.gov.au.
BMJ case reports
|June 5, 2024
概括
塔莫西芬是一种乳腺癌药物,很少引起肝损伤. 一名妇女在服用塔莫西芬6个月后出现肝炎,在停止服用药物后得到缓解.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 塔莫西芬是一种广泛用于乳腺癌治疗的选择性雌激素受体调节剂.
- 虽然与脂肪肝有关,但因他莫西芬引起的药物诱导性肝损伤并不常见.
- 这一案例突出了一个罕见的肝损伤案例,可能与他莫西芬治疗有关.
研究的目的:
- 报告一种罕见的药物诱导性肝损伤 (DILI) 病例,与他莫西芬相关.
- 描述tamoxifen诱导的肝毒性的临床表现,诊断工作和结果.
- 强调考虑他莫西芬作为乳腺癌患者肝酶升高的潜在原因的重要性.
主要方法:
- 一个50多岁的女性出现了不适和肝酶升高的病例报告.
- 进行了包括感染和自身免疫标记物,成像和FibroScan在内的全面调查.
- 进行肝脏活检以评估肝脏损伤的原因.
- 达摩西芬的治疗被停止,并监测患者的临床和生化反应.
主要成果:
- 患者在开始服用他莫西芬6个月后出现了没有黄的中度氨基转移酶升高.
- 广泛的调查排除了肝损伤的其他常见原因.
- 肝活检证实中度分叶性肝炎与肝细胞脱落.
- 终止他莫西芬导致肝酶和症状在3个月内消失.
结论:
- 塔莫西芬很少会引起药物诱导的严重肝损伤,表现为肝炎.
- 及时识别和药物取消对于管理他莫西芬诱导的肝毒性至关重要.
- 这一案例强调了需要警的必要性,关于潜在的肝脏并发症的患者在塔莫西芬治疗.
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