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[六年后再次接触氟烷后发生暴发性肝炎一例]

[A case of fulminant hepatitis after reexposure to halothane six years later].

作者信息

Koizumi T, Kambayashi T, Ichiyoshi T, Nakamura M, Ogihara M

出版信息

Masui. 1989 Sep;38(9):1212-6.

PMID:2810719
Abstract

We reported a case of halothane-induced fulminant hepatitis with acute renal failure which developed 6 days after reexposure to halothane. The patient was a 58-year-old female. She had a history of liver dysfunction after exposure to halothane 6 years previously. She had surgical treatment of clubfoot under halothane anesthesia in other hospital. Preoperative physical examination and laboratory data were normal. On the 6th post-operative day she abruptly developed high fever and general fatigue. Next day, she was transferred to our hospital. At admission, fulminant hepatitis complicated with acute renal failure was diagnosed with severe liver and renal damage. She was immediately treated with plasma exchange, glucose-insulin therapy, and hemodialysis. Serum transaminase level returned to normal value within a week. However, despite repeated hemodialysis, renal function did not improve, and she died of P. aeruginosa sepsis on 28th day after the operation. It may be suggested that in this patient hypersensitivity to halothane has persisted during the six years.

摘要

我们报告了一例氟烷诱导的暴发性肝炎合并急性肾衰竭的病例,该病例在再次接触氟烷6天后发病。患者为一名58岁女性。她6年前接触氟烷后有肝功能障碍病史。她在其他医院接受了氟烷麻醉下的马蹄内翻足手术治疗。术前体格检查和实验室数据均正常。术后第6天,她突然出现高热和全身乏力。次日,她被转至我院。入院时,诊断为暴发性肝炎合并急性肾衰竭,伴有严重的肝肾功能损害。她立即接受了血浆置换、葡萄糖-胰岛素疗法和血液透析治疗。血清转氨酶水平在一周内恢复正常。然而,尽管反复进行血液透析,肾功能仍未改善,她在术后第28天死于铜绿假单胞菌败血症。可以推测,该患者对氟烷的超敏反应在这六年中一直存在。

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