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氯氮平引起的肝毒性:病例报告及文献复习。

Hepatotoxicity induced by clozapine: a case report and review of literature.

机构信息

Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan ; Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

Neuropsychiatr Dis Treat. 2014 Aug 26;10:1585-7. doi: 10.2147/NDT.S67654. eCollection 2014.

Abstract

Clozapine is an effective antipsychotic drug but is associated with serious side effects. Most treatment guidelines give no clear recommendations on regular monitoring of liver function tests, even though up to 60% of patients experience elevations in hepatic transaminases, with 15% to 30% experiencing an elevation two to three times greater than normal. Though elevations in liver function tests are often transient and asymptomatic, there are many reported cases of clozapine-induced hepatotoxicity, with damage to the liver, involvement of multiple organs, and even fulminant liver failure arising with moderate clozapine doses. This case report describes a Chinese woman who developed hepatotoxicity on a low dose of clozapine, and reviews the relevant literature.

摘要

氯氮平是一种有效的抗精神病药物,但会引起严重的副作用。尽管高达 60%的患者会出现肝转氨酶升高,其中 15%至 30%的患者的肝转氨酶升高超过正常值的两倍至三倍,但大多数治疗指南并未就定期监测肝功能试验提出明确建议。尽管肝功能试验升高通常是短暂的且无症状,但已有许多氯氮平诱导的肝毒性报告病例,包括肝脏损伤、多器官受累,甚至在中等剂量氯氮平治疗时出现暴发性肝功能衰竭。本病例报告描述了一名中国女性在低剂量氯氮平治疗时发生肝毒性,并复习了相关文献。

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