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服用克拉霉素后导致慢性抗精神病药物治疗患者暴发性肝衰竭。

Fatal fulminant hepatitis following administration of clarithromycin in a patient chronically treated with antipsycotic drugs.

机构信息

Clinic of Infectious Disease, University Hospital, Bari, Italy.

出版信息

Immunopharmacol Immunotoxicol. 2013 Feb;35(1):191-4. doi: 10.3109/08923973.2012.705293. Epub 2012 Jul 17.

Abstract

BACKGROUND

Clarithromycin is a widely used antibiotic, especially prescribed for the treatment of respiratory tract infections, The drug is generally well tolerated. It is described as a very rare cause of fulminant liver failure.

CASE PRESENTATION

Herein we report a case of fatal fulminant hepatitis in a young patient. In his past history the patient presented documented episodes of hypertransaminasemia.

CONCLUSIONS

This case confirms that clarithromycin although very rarely, can be a cause of fulminant hepatitis, especially in patients with pre-existing liver damage. Although the presumption that clarithromycin hepatotoxicity is dose related is reasonable, an immune-toxicologic hypothesis cannot be excluded.

摘要

背景

克拉霉素是一种被广泛使用的抗生素,特别是用于治疗呼吸道感染。该药物通常具有良好的耐受性。据描述,克拉霉素是导致暴发性肝衰竭的极罕见原因。

病例介绍

在此我们报告一例年轻患者的致命性暴发性肝炎病例。该患者既往病史中曾有明确的高转氨酶血症发作。

结论

本病例证实克拉霉素虽然极为罕见,但可引起暴发性肝炎,特别是在存在预先存在的肝损伤的患者中。虽然克拉霉素肝毒性与剂量相关的假定是合理的,但不能排除免疫毒性假说。

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