Rivero Fernández M, Riesco J M, Moreira V F, Moreno A, López San Román A, Arranz G, Ruiz Del Arbol L
Servicios de Gastroenterología, Hospital Ramón y Cajal. Madrid. Spain.
Rev Esp Enferm Dig. 2008 Nov;100(11):720-3. doi: 10.4321/s1130-01082008001100010.
Adverse drug reactions (hepatotoxicity) are a frequent cause of acute liver injury with a wide clinical and histological spectrum. An early recognition of drug-related liver disease has been considered essential in clinical practice due to potential risks. In most cases exposure discontinuation improves the clinical picture.Steroids are used in a variety of clinical settings. However, intravenous steroids have rarely been associated with hepatotoxicity. We report the case of a middle-aged woman with multiple sclerosis who received a bolus of methylprednisolone on three occasions for the management of relapsing disease, with the development of repeated episodes of elevated liver enzymes after corticoid administration. In the third episode a liver biopsy was performed, which showed acute hepatitis with bridging necrosis; such histological picture has not been described before in patients treated with intravenous steroids.
药物不良反应（肝毒性）是急性肝损伤的常见原因，具有广泛的临床和组织学表现谱。由于存在潜在风险，在临床实践中早期识别药物相关性肝病被认为至关重要。在大多数情况下，停用相关药物可改善临床症状。类固醇在多种临床情况下使用。然而，静脉注射类固醇很少与肝毒性相关。我们报告了一例中年多发性硬化症女性患者，她因复发性疾病的治疗三次接受大剂量甲基泼尼松龙，在使用皮质类固醇后反复出现肝酶升高。在第三次发作时进行了肝活检，结果显示为伴有桥接坏死的急性肝炎；这种组织学表现此前在接受静脉注射类固醇治疗的患者中尚未有过描述。
