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[可能为雷尼替丁诱发的自身免疫性肝炎]

[Possibly ranitidine-induced autoimmune hepatitis].

作者信息

Luparini R L, Rotundo A, Mattace R, Marigliano V

机构信息

Cattedra di Gerontologia e Geriatria, Università degli Studi La Sapienza di Roma.

出版信息

Ann Ital Med Int. 2000 Jul-Sep;15(3):214-7.

Abstract

Approved for clinical use in peptic ulcer in 1983, ranitidine competitively inhibits the interaction of histamine with H2 receptors. The incidence of adverse reactions has been low and generally minor. After reviewing the literature on hepatitis associated with ranitidine use, we report the case of a young woman, affected by multiple sclerosis, who developed severe liver injury associated with the intake of this drug. This case meets the principal criteria necessary to establish a causal relationship between the administration of a drug and the verification of an adverse reaction. The singularity of our case with respect to others reported in the literature arises from the demonstration of an anatomo-pathological picture suggestive of toxic or idiosyncratic hepatitis after the initial administration that, at rechallenge, evolved into a histologic picture of autoimmune hepatitis. We believe that physicians should be aware of the potential hepatotoxicity of ranitidine.

摘要

雷尼替丁于1983年被批准用于临床治疗消化性溃疡,它能竞争性抑制组胺与H2受体的相互作用。不良反应的发生率一直较低,且通常较轻微。在查阅了与雷尼替丁使用相关的肝炎文献后,我们报告了一例患有多发性硬化症的年轻女性病例,她在服用该药物后出现了严重的肝损伤。该病例符合确定药物给药与不良反应之间因果关系所需的主要标准。我们的病例与文献中报道的其他病例的独特之处在于,首次给药后出现了提示毒性或特异质性肝炎的解剖病理图像,再次给药时则演变成了自身免疫性肝炎的组织学图像。我们认为医生应该意识到雷尼替丁潜在的肝毒性。

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