Clinic Institute of Gynecology, Obstetrics and Neonatologya, University of Barcelona, Hospital Clínic - Institut d'Investigacions Biomediques August Pi i Sunyer, Villarroel 170, Barcelona 08036, Spain.
Gynecol Endocrinol. 2009 Jul;25(7):419-22. doi: 10.1080/09513590902730754.
The nonsteroidal antiandrogenic drug flutamide is a safe and generally well-tolerated drug used for the treatment of prostate cancer and female hyperandrogenism.
We describe the case of a 26-year-old girl with amenorrhea and severe hirsutism who was treated with flutamide 250 mg/day and developed liver toxicity during therapy.
Other causes of liver toxicity were appropriately ruled out. The use of the standard Council for International Organization of Medical Sciences (CIOMS) scale and the Maria & Vitorino (M&V) scale indicated a highly probable relationship between the development of liver toxicity and flutamide therapy. Severe liver dysfunction has been rarely documented in women with hirsutism treated with flutamide, even though cases of fulminant liver failure have been described. The mechanisms responsible for the occurrence of hepatotoxicity during treatment with flutamide are unknown, but mitochondrial dysfunction seems to be implicated.
The potential of flutamide to act as a potent hepatotoxin should be kept in mind when treatment with this drug is being planned. This case reminds us that patients who are receiving flutamide should be regularly monitored for liver function. If drug-induced liver injury is suspected, flutamide must be discontinued promptly to avoid progression of liver injury.
非甾体类抗雄激素药物氟他胺是一种安全且通常耐受性良好的药物，用于治疗前列腺癌和女性高雄激素血症。
我们描述了一位 26 岁的女性患者，她因闭经和严重多毛症接受氟他胺 250mg/天治疗，在治疗过程中出现肝毒性。
其他引起肝毒性的原因已被排除。使用国际医学组织理事会（CIOMS）标准量表和 Maria & Vitorino（M&V）量表表明，肝毒性的发生与氟他胺治疗之间极有可能存在关联。尽管有描述过暴发性肝衰竭的病例，但氟他胺治疗多毛症女性患者的严重肝功能障碍很少见。氟他胺治疗期间发生肝毒性的机制尚不清楚，但线粒体功能障碍似乎与之相关。
在计划使用该药治疗时，应牢记氟他胺可能具有很强的肝毒性作用。该病例提醒我们，接受氟他胺治疗的患者应定期监测肝功能。如果怀疑药物性肝损伤，必须立即停止氟他胺治疗，以避免肝损伤的进展。
