Bhatty Osman, Selim Mohammad, Kassim Thamer, Chintalacheruvu Lakshmi, Urra Manuel, Shah Sonia, Haggerty Joseph, Gross John, Jhand Aravdeep, Pershwitz Gene, Gupta Jaya
Internal Medicine, Creighton University.
Internal Medicine, Creighton University School of Medicine.
Cureus. 2017 Jun 1;9(6):e1302. doi: 10.7759/cureus.1302.
A 71-year-old female with a past medical history of Philadelphia chromosome-positive chronic myelogenous leukemia on imatinib therapy, Sjogren's syndrome, and hypothyroidism presents with acute hepatitis. After a comprehensive workup ruling out viral, infectious and metabolic etiologies imatinib is stopped which results in immediate improvement. The biopsy is consistent with drug-induced liver damage; the patient is started on oral prednisone and discharged. Unfortunately, our patient's liver function does not improve over the course of the next week and she is readmitted for hepatic and renal failure. During this second admission patient's condition continues to deteriorate with concomitant gastric bleeding, renal injury, and cellulitis. She ultimately chooses a palliative approach.
一名71岁女性，既往有费城染色体阳性慢性髓性白血病病史，正在接受伊马替尼治疗，同时患有干燥综合征和甲状腺功能减退症，现出现急性肝炎。经过全面检查排除了病毒、感染和代谢性病因后，停用伊马替尼，患者病情立即改善。活检结果符合药物性肝损伤；患者开始口服泼尼松并出院。不幸的是，在接下来的一周里，我们这位患者的肝功能没有改善，她因肝肾功能衰竭再次入院。在第二次住院期间，患者的病情继续恶化，同时出现胃出血、肾损伤和蜂窝织炎。她最终选择了姑息治疗方法。
