Pratt D S, Dubois R S
Division of Gastroenterology, Wiliam Beaumont Hospital, Royal Oak, Michigan.
J Pediatr Gastroenterol Nutr. 1990 Feb;10(2):239-41. doi: 10.1097/00005176-199002000-00016.
Pemoline (Cylert) is an agent used to treat attention deficit disorders and other behavioral syndromes. There have, however, been three published reports of mild hepatic dysfunction in five patients coincident with pemoline therapy. We report two further cases of probable pemoline hepatotoxicity. One case involved a mild aminotransferase elevation in a 6-year-old who was on pemoline for 5 months. The second case, in an 11-year-old, developed hepatic failure with marked prolongation in prothrombin time nonresponsive to parenteral vitamin K, deep jaundice, and submassive hepatic necrosis. This patient had a long history of pemoline usage. Pharmacokinetics are briefly discussed. A spectrum of hepatic disease due to pemoline is considered and the importance of obtaining aminotransferase values before, during initiation, and throughout treatment is stressed.
匹莫林（Cylert）是一种用于治疗注意力缺陷障碍和其他行为综合征的药物。然而，已有三篇发表的报告称，五名患者在接受匹莫林治疗期间出现了轻度肝功能障碍。我们报告另外两例可能由匹莫林引起的肝毒性病例。一例是一名6岁儿童，服用匹莫林5个月后出现轻度转氨酶升高。另一例是一名11岁儿童，出现肝功能衰竭，凝血酶原时间显著延长，对胃肠外维生素K无反应，深度黄疸和亚大块肝坏死。该患者有长期服用匹莫林的病史。文中简要讨论了药代动力学。考虑了匹莫林所致肝病的范围，并强调了在开始治疗前、治疗开始时及整个治疗过程中获取转氨酶值的重要性。
