因甲状腺功能亢进症和法洛三联症患者使用他巴唑导致的慢加急性肝衰竭：病例报告。
Acute-on-chronic liver failure due to thiamazole in a patient with hyperthyroidism and trilogy of Fallot: case report.
机构信息
Department of Infectious Disease, Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
出版信息
BMC Gastroenterol. 2010 Aug 14;10:93. doi: 10.1186/1471-230X-10-93.
BACKGROUND
Thiamazole is a widely used antithyroid agent that has been approved for the treatment of hyperthyroidism. Although thiamazole-induced hepatotoxicity is a main side effect, it may progress to liver failure in a very few cases.
CASE PRESENTATION
We described a 24-year-old patient with hyperthyroidism and trilogy of Fallot, who developed liver failure due to thiamazole. Liver biopsy showed intrahepatic cholestasis, mild inflammatory infiltrates, as well as significant fibrosis, indicating both acute and chronic liver injuries. Although a series of potent therapies were given, the patient deceased due to severe liver decompensation.
CONCLUSIONS
This case suggests that thiamazole-induced hepatotoxicity in the setting of advanced fibrosis increases the risk of poor outcome. Regular liver function monitoring during thiamazole therapy is therefore important.
背景
他巴唑是一种广泛应用的抗甲状腺药物，已被批准用于治疗甲状腺功能亢进症。虽然他巴唑引起的肝毒性是主要的副作用，但在极少数情况下可能会进展为肝功能衰竭。
病例介绍
我们描述了一例 24 岁患有甲状腺功能亢进症和法洛四联症的患者，由于他巴唑而发生肝功能衰竭。肝活检显示肝内胆汁淤积、轻度炎症浸润以及明显的纤维化，表明存在急性和慢性肝损伤。尽管给予了一系列强效治疗，但由于严重的肝功能失代偿，患者最终死亡。
结论
本病例提示，在晚期纤维化的情况下，他巴唑引起的肝毒性会增加不良预后的风险。因此，在他巴唑治疗期间定期监测肝功能非常重要。
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