瑞戈非尼所致急性肝衰竭可能由肝血流受损引起：一例报告

Acute Liver Failure Due to Regorafenib May Be Caused by Impaired Liver Blood Flow: A Case Report.

作者信息

Akamine Takaki, Ando Koji, Oki Eiji, Saeki Hiroshi, Nakashima Yuichiro, Imamura Y U, Ohgaki Kippei, Maehara Yoshihiko

机构信息

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

出版信息

Anticancer Res. 2015 Jul;35(7):4037-41.

PMID:26124352

Abstract

BACKGROUND/AIM: Regorafenib has been approved for treatment of patients with unresectable or recurrent gastrointestinal stromal tumors resistant to imatinib or sunitinib. However, regorafenib has severe side-effects, including acute liver failure. We describe the case of a patient with multiple liver metastases of a small intestinal stromal tumor who experienced acute liver failure while being treated with regorafenib.

CASE REPORT

A 50-year-old patient with an unresectable small intestinal stromal tumor resistant to prior treatment with imatinib and sunitinib was started on regorafenib, but experienced acute liver failure 10 days later. Plasma exchange and steroid pulse treatment improved her liver function. During liver failure, abdominal ultrasonography showed to-and-fro flow in the portal vein. Lactate dehydrogenase concentration was markedly elevated to 1633 U/l. These findings indicate that liver failure in this patient was due to impaired liver blood flow.

CONCLUSION

Regorafenib may impair liver blood flow, inducing acute liver failure.

摘要

背景/目的：瑞戈非尼已被批准用于治疗对伊马替尼或舒尼替尼耐药的不可切除或复发性胃肠道间质瘤患者。然而，瑞戈非尼有严重的副作用，包括急性肝衰竭。我们描述了一例小肠间质瘤多发肝转移患者在接受瑞戈非尼治疗时发生急性肝衰竭的病例。

病例报告

一名50岁患者，患有不可切除的小肠间质瘤，对先前的伊马替尼和舒尼替尼治疗耐药，开始使用瑞戈非尼治疗，但10天后发生急性肝衰竭。血浆置换和类固醇冲击治疗改善了她的肝功能。在肝衰竭期间，腹部超声显示门静脉有往返血流。乳酸脱氢酶浓度显著升高至1633 U/l。这些发现表明该患者的肝衰竭是由于肝血流受损所致。