Merlob P, Mor N, Litwin A
Department of Neonatology, Beilinson Medical Center, Petah Tiqva, Israel.
Ann Pharmacother. 1992 Dec;26(12):1563-5. doi: 10.1177/106002809202601215.
A case is reported of a carbamazepine (CBZ)-treated epileptic mother whose newborn presented with transient hepatic dysfunction characterized by direct hyperbilirubinemia and high concentrations of gamma-glutamyltransferase (GGT).
Information was obtained from case reports, clinical trials, and relevant bibliographic laboratory studies.
Data from case reports were evaluated and compared with those from our patient. The hepatotoxic reactions together with the microsomal enzymatic induction of CBZ were reviewed.
A female infant born to an epileptic mother treated with CBZ throughout pregnancy and breastfeeding presented with transient direct hyperbilirubinemia and high concentrations of GGT. The characteristics of her transient hepatic dysfunction were: early appearance (during the first day of life); discrepancy between the normal liver enzymes and high GGT concentrations; slow decrease of GGT, which nevertheless remained at above-normal concentrations even after the complete disappearance of direct hyperbilirubinemia; and spontaneous resolution in spite of only occasional breastfeeding. The possible explanations of this transient hepatic dysfunction (like enzymatic induction) are discussed.
CBZ-induced hepatic dysfunction in neonates appears to have different clinical expressions. Infants of epileptic mothers treated with CBZ throughout pregnancy and breastfeeding should be carefully monitored for possible adverse effects.
报告一例接受卡马西平（CBZ）治疗的癫痫母亲，其新生儿出现以直接胆红素血症和高浓度γ-谷氨酰转移酶（GGT）为特征的短暂性肝功能障碍。
信息来自病例报告、临床试验及相关文献实验室研究。
对病例报告中的数据进行评估，并与我们患者的数据进行比较。回顾了卡马西平的肝毒性反应及微粒体酶诱导作用。
一名在整个孕期及哺乳期均接受卡马西平治疗的癫痫母亲所生的女婴出现了短暂性直接胆红素血症和高浓度的GGT。其短暂性肝功能障碍的特点为：出现早（出生第一天）；肝酶正常与GGT浓度高之间存在差异；GGT下降缓慢，即使直接胆红素血症完全消失后仍维持在高于正常的浓度；尽管仅偶尔母乳喂养，但仍可自发缓解。讨论了这种短暂性肝功能障碍的可能原因（如酶诱导）。
卡马西平所致新生儿肝功能障碍似乎有不同的临床表现。对在整个孕期及哺乳期均接受卡马西平治疗的癫痫母亲的婴儿，应密切监测是否可能出现不良反应。
