Kawasaki Atsushi, Mimatsu Kenji, Kuboi Youichi, Kano Hisao, Oida Takatsugu, Amano Sadao
Dept. of Surgery, Social Insurance Yokohama Central Hospital.
Gan To Kagaku Ryoho. 2009 Nov;36(11):1901-3.
We report a case of drug-induced liver injury associated with uracil/tegafur(UFT) + folinate (Uzel) therapy. A 73-year-old woman had undergone right hemicolectomy with ascending colon cancer in April 2008. Postoperative diagnosis was tub2, pSS, pN0, fStage II. We administered UFT + Uzel therapy(UFT 500 mg/day, Uzel 75 mg/day)as adjuvant chemotherapy after operation for 6 weeks. Two weeks after the first drug administration, she visited our hospital complaining of anorexia and general malaise. Laboratory data showed elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). She was admitted to the hospital with a diagnosis of grade 3 liver dysfunction. We supposed the cause of this liver dysfunction to be a drug-induced liver injury associated with UFT + Uzel, and administered drugs to the patient for liver protection. With time, the symptoms and elevation of AST, ALT and ALP recovered to the normal level. This case was diagnosed as drug-induced allergic liver injury by UFT, because the result of the drug lymphocyte stimulate test (DLST) was positive.
我们报告一例与尿嘧啶/替加氟（UFT）+亚叶酸（Uzel）治疗相关的药物性肝损伤病例。一名73岁女性于2008年4月因升结肠癌接受了右半结肠切除术。术后诊断为tub2、pSS、pN0、fStage II。术后我们给予UFT+Uzel治疗（UFT 500mg/天，Uzel 75mg/天）作为辅助化疗，持续6周。首次用药两周后，她因厌食和全身不适前来我院就诊。实验室检查数据显示天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和碱性磷酸酶（ALP）升高。她因诊断为3级肝功能障碍入院。我们推测这种肝功能障碍的原因是与UFT+Uzel相关的药物性肝损伤，并给予患者保肝药物治疗。随着时间推移，症状以及AST、ALT和ALP的升高恢复到正常水平。该病例被诊断为UFT引起的药物性过敏性肝损伤，因为药物淋巴细胞刺激试验（DLST）结果为阳性。
