Ebrahim Vivian, Albeldawi Mazen, Chiang Dian Jung
Cleveland Clinic, Cleveland, Ohio, USA.
BMJ Case Rep. 2012 Dec 13;2012:bcr2012007665. doi: 10.1136/bcr-2012-007665.
A 55-year-old woman taking over-the-counter (OTC) glucosamine developed symptomatic hepatotoxicity. Several of her liver enzymes were elevated to 10 times the upper limit of normal. One week after discontinuing glucosamine, serum transaminases fell dramatically, with some returning to normal limits. Four weeks after glucosamine was discontinued, all her liver tests were normal. Rechallenge was not attempted. The potential causes of hepatocellular injury were evaluated. Glucosamine is a dietary supplement available in a wide variety of commercial preparations, primarily used for joint relief in osteoarthritis. Despite the extensive use of glucosamine supplements, significant elevations of transaminases are rare. The mechanism of hepatotoxicity in many OTC herbal preparations is unknown. It is vital for physicians to elicit a careful history of OTC medications and educate their patients on their potential adverse effects.
一名55岁的女性在服用非处方（OTC）葡萄糖胺后出现了有症状的肝毒性。她的几种肝酶升高到正常上限的10倍。停用葡萄糖胺一周后，血清转氨酶大幅下降，部分恢复到正常范围。停用葡萄糖胺四周后，她所有的肝脏检查都恢复正常。未尝试再次用药。对肝细胞损伤的潜在原因进行了评估。葡萄糖胺是一种膳食补充剂，有多种商业制剂，主要用于缓解骨关节炎的关节疼痛。尽管葡萄糖胺补充剂被广泛使用，但转氨酶显著升高的情况很少见。许多非处方草药制剂的肝毒性机制尚不清楚。医生详细了解患者非处方药物使用史并告知其潜在不良反应至关重要。
