Merlani G, Fox M, Oehen H P, Cathomas G, Renner E L, Fattinger K, Schneemann M, Kullak-Ublick G A
Medizinische Klinik B, Department of Internal Medicine, University Hospital, Zurich, Switzerland.
Eur J Clin Pharmacol. 2001 Jul;57(4):321-6. doi: 10.1007/s002280100312.
This report describes a 57-year-old female patient with chronic lumbago, who died from the sequelae of acute liver failure induced by nimesulide medication. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) which preferentially inhibits cyclo-oxygenase 2 and has been associated with a total of 13 reported cases of severe liver injury including our case. On the basis of the literature reports, the following features of nimesulide-associated hepatotoxicity were identified: female sex (84% of cases), age (mean age 62 years), jaundice as a primary manifestation (90%) and the absence of peripheral blood eosinophilia. The average duration of therapy of the published cases was 62 days (range 7-180 days). Based on spontaneous reports to the World Health Organization, nimesulide induces a high proportion of severe adverse hepatic reactions compared with other NSAIDs registered in Switzerland. Hepatotoxicity thus represents an important risk factor of nimesulide usage.
本报告描述了一名患有慢性腰痛的57岁女性患者，她死于尼美舒利药物引起的急性肝衰竭后遗症。尼美舒利是一种非甾体抗炎药（NSAID），它优先抑制环氧化酶2，包括我们的病例在内，总共已有13例关于严重肝损伤的报告病例。根据文献报道，确定了尼美舒利相关肝毒性的以下特征：女性（84%的病例）、年龄（平均年龄62岁）、黄疸为主要表现（90%）以及外周血嗜酸性粒细胞缺乏。已发表病例的平均治疗持续时间为62天（范围7 - 180天）。根据向世界卫生组织的自发报告，与瑞士注册的其他NSAIDs相比，尼美舒利引起严重不良肝反应的比例较高。因此，肝毒性是尼美舒利使用的一个重要风险因素。
