Björnsson E, Nordlinder H, Olsson R
Department of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Göteborg, Sweden.
Hepatogastroenterology. 2002 Jan-Feb;49(43):252-4.
Metronidazol, a commonly used antibiotic drug, has been very rarely associated with hepatotoxicity. In particular, no reports have appeared in the literature about cases of metronidazol-associated severe hepatotoxicity, leading to liver transplantation or death. We report on a case of acute fulminant liver failure in a young woman, who had, two years previously, developed jaundice after intake of metronidazol. During the current hospitalization, metronidazol treatment had been undertaken two weeks previously and also this time the patient developed severe hepatocellular injury and cholestasis. A viral etiology was ruled out as well as vascular, metabolic and malignant etiology. Although, the cause of the liver injury in this case is not proven, the relationship between this drug and two occasions of severe liver damage, suggests a positive challenge as well as rechallenge. An International algorithm was used for the assessment of the causality of a drug in this case of acute liver injury and a "probable" classification was obtained.
甲硝唑是一种常用的抗生素药物，与肝毒性的关联非常罕见。特别是，文献中尚未出现关于甲硝唑相关严重肝毒性导致肝移植或死亡病例的报道。我们报告了一例年轻女性急性暴发性肝衰竭的病例，该女性两年前在服用甲硝唑后出现黄疸。在本次住院期间，两周前曾进行过甲硝唑治疗，此次患者再次出现严重的肝细胞损伤和胆汁淤积。排除了病毒病因以及血管、代谢和恶性病因。虽然该病例中肝损伤的原因尚未得到证实，但这种药物与两次严重肝损伤之间的关系表明存在阳性激发以及再激发。在该急性肝损伤病例中使用了国际算法来评估药物因果关系，得出了“可能”的分类。
