Morisaki Tomohito, Ohnita Ken, Takeshima Fuminao, Akazawa Yuko, Yamaguchi Naoyuki, Miyaaki Hisamitsu, Taura Naohiro, Ichikawa Tatsuki, Isomoto Hajime, Toriyama Hiroshi, Nakao Kazuhiko
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2011 Feb;108(2):245-52.
We report a case of sclerosing cholangitis caused by oral chemotherapy with S-1. A 79-year-old woman with a history of hypertension presented with epigastric discomfort. Upper gastrointestinal endoscopy revealed advanced gastric cancer in the gastric antrum and abdominal computed tomography showed multiple lymph node metastasis. The patient underwent chemotherapy with S-1. Since 2 months later, blood chemistry analysis showed liver dysfunction and hyperbilirubinemia, and chemotherapy was discontinued. Endoscopic retrograde cholangiopancreatography revealed stenosis of the bile duct at the hepatic hilum. There was no evidence of tumor in the liver. We diagnosed chemotherapy-induced sclerosing cholangitis (CISC) caused by S-1. Although treatment with ursodeoxycholic acid and corticosteroids was temporarily effective, she eventually died of CISC and gastric cancer. To the best of our knowledge, this is the first case report of CISC caused by S-1. We present this rare condition with a review of the literature.
我们报告一例由口服化疗药物S-1引起的硬化性胆管炎病例。一名有高血压病史的79岁女性出现上腹部不适。上消化道内镜检查显示胃窦部进展期胃癌,腹部计算机断层扫描显示多发淋巴结转移。该患者接受了S-1化疗。2个月后,血液生化分析显示肝功能障碍和高胆红素血症,化疗停药。内镜逆行胰胆管造影显示肝门部胆管狭窄。肝脏未发现肿瘤证据。我们诊断为由S-1引起的化疗性硬化性胆管炎(CISC)。尽管熊去氧胆酸和皮质类固醇治疗暂时有效,但她最终死于CISC和胃癌。据我们所知,这是首例由S-1引起的CISC病例报告。我们结合文献复习介绍这种罕见疾病。