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复发性大剂量静脉注射琥珀酸甲泼尼龙脉冲治疗诱发多发性硬化症患者肝损伤。

Recurrent high-dose intravenous methylprednisolone succinate pulse therapy-induced hepatopathy in a patient with multiple sclerosis.

机构信息

First Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.

出版信息

Med Princ Pract. 2011;20(3):291-3. doi: 10.1159/000323835. Epub 2011 Mar 29.

Abstract

OBJECTIVE

We describe recurrent and reversible hepatopathy in a girl with multiple sclerosis (MS) after glucocorticoid pulse therapy, to point out the possibility that glucocorticoid may harm the liver.

CLINICAL PRESENTATION AND INTERVENTION

An 11-year-old girl with MS, who was treated with high-dose methylprednisolone succinate pulse therapy, developed elevation of liver enzymes. The episodes of hepatopathy occurred 1-5 weeks after the therapy and disappeared within several weeks. The examination for antinuclear antibody and viruses which can cause hepatitis produced negative results.

CONCLUSION

The present case emphasizes the possible effects of high-dose glucocorticoids in the induction of liver enzymes and the importance of follow-up liver tests after pulse therapy.

摘要

目的

我们描述了一例多发性硬化症(MS)女孩在接受糖皮质激素脉冲治疗后出现复发性和可逆转性肝损伤,以指出糖皮质激素可能损害肝脏的可能性。

临床表现和干预

一名 11 岁的 MS 女孩接受了大剂量琥珀酸甲泼尼龙脉冲治疗后,出现肝酶升高。肝损伤发作发生在治疗后 1-5 周,数周内消失。抗核抗体和可引起肝炎的病毒检查结果均为阴性。

结论

本病例强调了大剂量糖皮质激素在诱导肝酶中的可能作用,以及脉冲治疗后进行肝脏检查随访的重要性。

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