Faculty of Medicine and Dentistry, University of Western Australia, Australia.
Can Respir J. 2012 Jan-Feb;19(1):e1-2. doi: 10.1155/2012/567024.
Endothelin receptor antagonists are commonly used in the treatment of pulmonary hypertension. Sitaxsentan, a selective endothelin A receptor blocker, induces a mild transaminitis in approximately 3% to 5% of patients, but rarely an acute severe hepatitis. A case involving a 61-year-old female with sitaxsentan-induced acute severe liver failure is presented. Depite withdrawal of therapy, her liver tests failed to improve. After six weeks of monitoring, the patient was administered high-dose corticosteroids, with a good clinical and biochemical response. While endothelin receptor antagonists are postulated to cause hepatitis by inhibition of a bile salt transporter pump, an immune-mediated or idiosyncratic mechanism should be considered.
内皮素受体拮抗剂常用于治疗肺动脉高压。西他生坦是一种选择性内皮素 A 受体阻滞剂，约有 3%至 5%的患者会出现轻微的转氨升高，但很少发生急性重症肝炎。本文报道了一例 61 岁女性因使用西他生坦引起急性重症肝衰竭的病例。尽管停用了治疗药物，但她的肝功能检查仍未见改善。在监测 6 周后，患者接受了大剂量皮质类固醇治疗，取得了良好的临床和生化反应。虽然内皮素受体拮抗剂被认为是通过抑制胆盐转运泵而导致肝炎，但也应考虑免疫介导或特发性机制。
