Bolesta Scott, Roslund Brian P
Department of Pharmacy Practice, Nesbitt College of Pharmacy and Nursing, Wilkes University, Wilkes-Barre, PA 18766, USA.
Am J Health Syst Pharm. 2008 Jan 1;65(1):37-41. doi: 10.2146/ajhp070164.
A case of mild hepatocellular injury associated with the administration of telithromycin in a patient with no risk factors for hepatotoxicity is presented.
A 44-year-old man with no significant past medical history arrived at the emergency room after six days of high fever, chills, headache, neck stiffness, and back pain. Five days earlier, he visited a family medicine clinic for his symptoms and oral telithromycin 800 mg daily was prescribed for a suspected upper-respiratory-tract infection. The patient stopped taking the drug after three days due to persistent symptoms. On admission, the patient's laboratory tests revealed an aspartate transaminase (AST) concentration of 68 units/L, an alanine transaminase (ALT) value of 155 units/L, and an erythrocyte sedimentation rate of 40 mm/hr. The patient was not taking any long-term medications, had taken only aspirin for his fever, and denied the use of alcohol and illegal drugs. The patient was admitted to the general medical unit with a diagnosis of possible viral hepatitis. His urine culture was negative, and serology tests later revealed no evidence of hepatitis A, B, or C. Ibuprofen, pantoprazole, and enoxaparin were prescribed. On hospital day 2, the patient's AST and ALT concentrations had decreased to 50 and 110 units/L, respectively. By day 3, the patient's symptoms had improved and he remained afebrile. His AST and ALT values had further decreased to 41 and 105 units/L, respectively. He was then diagnosed with acute viral upper-respiratory-tract infection with mild hepatotoxicity associated with telithromycin and was discharged home with orders for follow-up at the family medicine clinic.
A patient without risk factors for hepatotoxicity developed mild elevations in hepatic transaminases after receiving telithromycin for the treatment of a suspected upper-respiratory-tract infection.
报告1例在无肝毒性危险因素的患者中，使用泰利霉素后出现轻度肝细胞损伤的病例。
一名44岁男性，既往无重大病史，在出现高热、寒战、头痛、颈部僵硬和背痛6天后到急诊室就诊。5天前，他因这些症状前往一家家庭医学诊所就诊，因疑似上呼吸道感染，医生开具了每日800毫克的口服泰利霉素。3天后，由于症状持续，患者停用了该药。入院时，患者的实验室检查显示天冬氨酸转氨酶（AST）浓度为68单位/升，丙氨酸转氨酶（ALT）值为155单位/升，红细胞沉降率为40毫米/小时。患者未服用任何长期药物，仅服用过阿司匹林退热，否认饮酒和使用非法药物。患者以可能的病毒性肝炎诊断被收入普通内科病房。他的尿培养结果为阴性，血清学检查后来显示没有甲型、乙型或丙型肝炎的证据。开具了布洛芬、泮托拉唑和依诺肝素。住院第2天，患者的AST和ALT浓度分别降至50和110单位/升。到第3天，患者的症状有所改善，体温恢复正常。他的AST和ALT值进一步分别降至41和105单位/升。随后他被诊断为急性病毒性上呼吸道感染伴与泰利霉素相关的轻度肝毒性，并出院回家，医嘱在家庭医学诊所进行随访。
一名无肝毒性危险因素的患者在接受泰利霉素治疗疑似上呼吸道感染后出现了肝转氨酶轻度升高。
