Levine Joshua A, Ann Lo Amy, Wallia Amisha, Rogers Melinda, VanWagner Lisa B
Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL.
ACG Case Rep J. 2016 Dec 7;3(4):e169. doi: 10.14309/crj.2016.142. eCollection 2016 Aug.
Sodium-glucose cotransporter 2 inhibitors are a new class of oral hypoglycemic agents, and thus safety data are limited. We present a 48-year-old woman with type 2 diabetes mellitus and Child's Class A cirrhosis secondary to nonalcoholic steatohepatitis presenting with jaundice and acute cholestatic liver injury. Other than starting dapagliflozin, she reported no medication changes or supplement use. Before treatment, her total bilirubin was 1.2 mg/dL. On admission, her liver values were elevated and liver biopsy was consistent with drug-induced liver injury. This report raises awareness about the potential hepatotoxic effects of dapagliflozin, particularly in patients with chronic liver disease.
钠-葡萄糖协同转运蛋白2抑制剂是一类新型口服降糖药，因此安全性数据有限。我们报告一名48岁患有2型糖尿病且继发于非酒精性脂肪性肝炎的Child A级肝硬化女性，出现黄疸和急性胆汁淤积性肝损伤。除开始使用达格列净外，她未报告用药变化或补充剂使用情况。治疗前，她的总胆红素为1.2mg/dL。入院时，她的肝功能指标升高，肝活检结果符合药物性肝损伤。本报告提高了对达格列净潜在肝毒性作用的认识，尤其是在慢性肝病患者中。
