Hayashi T, Takahashi T, Minami T, Akaike J, Kasahara K, Adachi M, Hinoda Y, Takahashi S, Hirayama T, Imai K
First Department of Internal Medicine, Sapporo Medical University, Japan.
J Gastroenterol. 2001 Nov;36(11):783-6. doi: 10.1007/s005350170022.
We describe a 47-year-old woman with severe aplastic anemia with genital bleeding who developed acute severe hepatitis after the administration of danazol while she was receiving cyclosporin. She had been diagnosed with severe aplastic anemia 1 year previously and, while hospitalized, had received methyl prednisolone pulse therapy, which was not successful. She was then referred to our hospital. She was treated with antithymocyte globulin, cyclosporin, granulocyte colony-stimulating factor, and methyl prednisolone; a good response was achieved after 3 months of this therapy. Subsequently, oral administration of cyclosporin was continued, but she was readmitted to our hospital when pancytopenia gradually developed and the genital bleeding recurred. Danazol was administered for pancytopenia and endometriosis. Four days after the first administration of danazol, epigastric pain occurred, and the danazol was stopped. Eighteen days after the first danazol administration, very severe hepatic injury occurred abruptly. The patient died of hepatic failure. Postmortem examination revealed centrilobular massive necrosis of the liver. Danazol was implicated as the agent responsible for causing the hepatic failure. Drug interactions between danazol and cyclosporin may cause adverse effects.
我们描述了一名47岁患有严重再生障碍性贫血并伴有生殖器出血的女性，她在接受环孢素治疗期间服用达那唑后发生了急性重症肝炎。她在1年前被诊断为严重再生障碍性贫血，住院期间接受了甲泼尼龙冲击治疗，但未成功。随后她被转诊至我院。她接受了抗胸腺细胞球蛋白、环孢素、粒细胞集落刺激因子和甲泼尼龙治疗；该治疗3个月后取得了良好疗效。随后继续口服环孢素，但当全血细胞减少逐渐出现且生殖器出血复发时，她再次入院。给予达那唑治疗全血细胞减少和子宫内膜异位症。首次服用达那唑4天后，出现上腹部疼痛，达那唑停用。首次服用达那唑18天后，突然发生非常严重的肝损伤。患者死于肝衰竭。尸检显示肝脏小叶中心性大片坏死。达那唑被认为是导致肝衰竭的药物。达那唑与环孢素之间的药物相互作用可能会引起不良反应。
