卡瓦草药诱导的肝损伤,通过更新的RUCAM验证
Sahan Withanage1,2, Carl Cosgrave1,2, Shoa Zafir3
1University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia, barwonhealth.org.au.
Case reports in gastrointestinal medicine
|January 1, 2026
概括
卡瓦的消费可以导致急性肝损伤,肝酶 (ALT和AST) 升高. 临床医生应考虑卡瓦作为一种潜在的草药诱导性肝损伤 (HILI) 的原因,患者有不明原因的透视膜炎.
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
- 草药研究 草药研究
背景情况:
- 草药诱导的肝损伤 (HILI) 是一个新兴的问题,草药的使用越来越多.
- 传统的太平洋岛屿饮料卡瓦 (Kava) 曾经与肝脏损伤有关.
- 快速识别HILI原因对于患者管理至关重要.
研究的目的:
- 报告一种与卡瓦消费暂时相关的急性肝损伤病例.
- 为了突出卡瓦作为草药诱导的肝损伤的原因的潜力.
- 为了提高临床医生对卡瓦诱导的肝毒性意识.
主要方法:
- 一个46岁的男性出现疲劳和黄的案例研究.
- 评估肝功能测试 (ALT,AST) 和成像研究.
- 肝脏活检以评估肝细胞损伤.
- 更新了罗塞尔·乌克拉夫因果关系评估方法 (RUCAM) 的得分计算.
主要成果:
- 患者在使用卡瓦后显示ALT (1546U/L) 和AST (920U/L) 的显著升高.
- 肝脏活检显示肝细胞亡和气球变性.
- 更新后的RUCAM分数为7,表明可能是卡瓦诱导的肝损伤.
- 肝酶在没有进一步干预的情况下在 kava 停止后正常化.
结论:
- 卡瓦的消费可以导致急性肝损伤,呈现为显著的透氨炎.
- 在无法解释的肝酶升高的差异诊断中,应考虑卡瓦,特别是在有相关暴露的患者中.
- 由于其越来越受欢迎,对卡瓦诱导的肝损伤的病原性进行进一步的研究是有必要的.
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