与半抗原和自身抗原特异性IgG4抗体相关的地氟烷肝炎
Desflurane hepatitis associated with hapten and autoantigen-specific IgG4 antibodies.
作者信息
Anderson James S, Rose Noel R, Martin Jackie L, Eger Edmond I, Njoku Dolores B
机构信息
Anesthesia Consultants Associated, El Paso, Texas, USA.
出版信息
Anesth Analg. 2007 Jun;104(6):1452-3, table of contents. doi: 10.1213/01.ane.0000263275.10081.47.
Abstract
BACKGROUND
Three cases of drug-induced liver injury (DILI) have been reported after desflurane anesthesia. However, no previous reports have detected serum autoantibodies such as that reported with DILI from halothane or isoflurane.
METHODS AND RESULTS
We describe the first documentation of cytochrome P450 2E1 IgG4 autoantibodies, as well as 58 kDa endoplasmic reticulum protein and trifluoroacetyl chloride hapten-specific IgG4 antibodies, in a patient who developed DILI after desflurane anesthesia.
CONCLUSIONS
These findings suggest that allergic and autoimmune mechanisms have critical roles in the development of desflurane DILI.
摘要
背景
已有三例在地氟烷麻醉后发生药物性肝损伤（DILI）的报告。然而，此前尚无报告检测到血清自身抗体，比如与氟烷或异氟烷所致DILI相关的自身抗体。
方法与结果
我们报告了首例在接受地氟烷麻醉后发生DILI的患者体内检测到细胞色素P450 2E1 IgG4自身抗体以及58 kDa内质网蛋白和三氟乙酰氯半抗原特异性IgG4抗体的情况。
结论
这些发现表明，过敏和自身免疫机制在地氟烷所致DILI的发生过程中起关键作用。
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