Ngo M D, Hagège H, Rosa I, Cartier V A, Lons T, Gordin J, Chousterman M
Service d'Hépato-Gastroentérologie, Centre Hospitalier Intercommunal de Créteil.
Presse Med. 1999 Nov 6;28(34):1873-5.
Cyclosporin is used for the treatment of corticosteroid-resistant inflammatory bowel disease. Secondary liver disease is a risk.
Acute hepatitis with predominant major transaminase elevation occurred in a patient treated with cyclosporin for corticosteroid-resistant Crohnś disease. No viral, alcoholic, autoimmune or metabolic cause could be incriminated. Complete cure was achieved after withdrawal of cyclosporin.
Only one case of cholestatic hepatitis has been reported in chronic inflammatory bowel disease. Cyclosporin was the probable cause in our case as other causes of acute hepatitis were ruled out and withdrawal led to cure. Cyclosporin can induce abnormal liver tests in 25% of cases. If reducing dose does not lead to improvement, it may be necessary to discontinue cyclosporin. Regular liver tests would thus be required for patients given cyclosporin for chronic inflammatory bowel disease.
环孢素用于治疗对皮质类固醇耐药的炎症性肠病。存在继发性肝病风险。
一名因对皮质类固醇耐药的克罗恩病而接受环孢素治疗的患者发生了以主要转氨酶升高为主的急性肝炎。未发现病毒、酒精、自身免疫或代谢方面的病因。停用环孢素后实现了完全治愈。
在慢性炎症性肠病中仅报告过一例胆汁淤积性肝炎病例。在我们的病例中，环孢素可能是病因，因为排除了急性肝炎的其他病因，且停药后实现了治愈。环孢素可在25%的病例中导致肝功能检查异常。如果降低剂量没有改善，可能有必要停用环孢素。因此，对于因慢性炎症性肠病而接受环孢素治疗的患者，需要定期进行肝功能检查。
