[阿莫西林/克拉维酸所致肝毒性：病例报告]

[Hepatotoxicity by amoxicillin/clavulanic acid: case report].

作者信息

Soza A, Riquelme F, Alvarez M, Duarte I, Glasinovic J C, Arrese M

机构信息

Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile.

出版信息

Rev Med Chil. 1999 Dec;127(12):1487-91.

PMID:10835757

Abstract

We report a 72 years old diabetic male that, after the use of combined amoxicillin-clavulanic acid, developed pruritus and jaundice. Liver function tests showed serum total bilirubin of 4.3 mg/dL aspartate aminotransferase 140 U/l (normal < 35 U/L), alanine aminotransferase 470 U/L (normal < 40) and alkaline phosphatases of 400 U/L (normal < 100). Serology for hepatitis A, B and C viruses was negative, ERCP showed a normal biliary tree and liver biopsy disclosed a cholestatic hepatitis. Ursodeoxycholic was started to relieve pruritus. Liver function tests improved shortly thereafter, suggesting that this drug may be useful in the treatment of drug induced cholestasis.

摘要

我们报告一名72岁的糖尿病男性，在使用阿莫西林-克拉维酸联合制剂后出现瘙痒和黄疸。肝功能检查显示血清总胆红素为4.3mg/dL，天冬氨酸转氨酶为140U/l（正常<35U/L），丙氨酸转氨酶为470U/L（正常<40），碱性磷酸酶为400U/L（正常<100）。甲型、乙型和丙型肝炎病毒血清学检查均为阴性，内镜逆行胰胆管造影显示胆管树正常，肝脏活检显示为胆汁淤积性肝炎。开始使用熊去氧胆酸来缓解瘙痒。此后不久肝功能检查有所改善，提示该药可能对药物性胆汁淤积的治疗有用。