Neyns Bart, Hoorens Anne, Stupp Roger
Acta Neurol Belg. 2008 Dec;108(4):131-4.
Glioblastoma patients undergoing treatment with surgery followed by radiation and temozolomide chemotherapy often develop a state of immunosuppression and are at risk for opportunistic infections and reactivation of hepatitis and herpes viruses. We report the case of a 48-year-old glioblastoma patient who developed acute cholestatic hepatitis with hepatic failure during adjuvant treatment with temozolomide and the integrin inhibitor cilengitide. A viral hepatitis was excluded and valproic acid treatment was stopped. Upon normalisation of the liver tests, temozolomide treatment was resumed without perturbation of the liver tests. Valproic acid related idiosyncratic drug induced hepatotoxicity should be considered as a differential diagnosis in glioblastoma patients undergoing adjuvant therapy.
接受手术，随后进行放疗和替莫唑胺化疗的胶质母细胞瘤患者常出现免疫抑制状态，有发生机会性感染以及肝炎病毒和疱疹病毒再激活的风险。我们报告了一例48岁的胶质母细胞瘤患者，该患者在接受替莫唑胺和整合素抑制剂西仑吉肽辅助治疗期间发生了伴有肝衰竭的急性胆汁淤积性肝炎。排除了病毒性肝炎，并停用了丙戊酸治疗。肝功能检查恢复正常后，恢复了替莫唑胺治疗，且肝功能检查未受干扰。在接受辅助治疗的胶质母细胞瘤患者中，应将丙戊酸相关的特异质性药物性肝毒性视为鉴别诊断。
