Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Allergy Asthma Immunol Res. 2013 Jul;5(4):245-7. doi: 10.4168/aair.2013.5.4.245. Epub 2013 May 7.
Idiopathic anaphylaxis is characterized by recurrent anaphylaxis without a known trigger. The coexistence of acute liver injury with idiopathic anaphylaxis is rare, even in cases of severe anaphylaxis such as shock. An unusual case involving repeated episodes of anaphylactic shock accompanied by acute liver injury is described here. A 36-year-old woman who experienced anaphylaxis due to an unknown cause was referred to our hospital because of marked elevations in her liver enzyme levels. After a thorough evaluation to determine the cause of the acute liver injury, viral infection, drug use, and autoimmune hepatitis were excluded. The episodes were accompanied by elevated liver enzymes, which suggested that this was a case of anaphylaxis followed by acute liver injury. The patient will have to use self-injectable epinephrine to prevent future hepatic failure.
特发性过敏反应的特征是反复发生过敏反应而无已知诱因。特发性过敏反应伴发急性肝损伤较为罕见,即使在严重过敏反应(如休克)中也很少见。本文报道了一例罕见的反复发作的过敏性休克伴急性肝损伤病例。一位 36 岁女性因不明原因发生过敏反应,因肝酶水平显著升高而转至我院。在彻底评估以确定急性肝损伤的病因后,排除了病毒感染、药物使用和自身免疫性肝炎。这些发作伴随着肝酶升高,提示这是一种过敏反应后继发急性肝损伤的情况。患者将不得不使用自我注射肾上腺素来预防未来的肝衰竭。