多种药物不良反应及基因多态性检测：1例结果为阴性的病例报告
Multiple adverse drug reactions and genetic polymorphism testing: A case report with negative result.
作者信息
Arellano Ana Lucía, Martin-Subero Marta, Monerris Mar, LLerena Adrián, Farré Magí, Montané Eva
机构信息
Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Barcelona Department of Pharmacology, Therapeutics, and Toxicology, Universitat Autònoma de Barcelona, Barcelona Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, Barcelona FIDMAG Research Foundation, Barcelona Department of Anesthesiology and Reanimation, Pain Unit, Hospital Universitari Germans Trias i Pujol, Barcelona CICAB Clinical Research Center, Extremadura University Hospital and Medical School, Badajoz, Spain.
出版信息
Medicine (Baltimore). 2017 Nov;96(45):e8505. doi: 10.1097/MD.0000000000008505.
RATIONALE
Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6.
PATIENT CONCERNS
We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period.
INTERVENTIONS AND OUTCOMES
A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency.
LESSONS
Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.
原理
药物代谢途径的缺陷可以解释为什么一些患者有多次药物不良反应（ADR）的病史；因此，我们旨在分析一名与通过CYP2D6进行常见肝脏代谢途径的药物相关的多次ADR患者的基因多态性。
患者情况
我们报告了一名在2年内出现与阿米替林、曲马多和度洛西汀相关的精神病和高血压的患者。
干预措施与结果
进行了药物遗传学检测以评估CYP2D6酶的致病作用，但未显示代谢缺陷。
经验教训
尽管该报告病例结果为阴性；但对细胞色素P450同工酶多态性进行分型在一些有多次ADR病史的患者中可能是一种有用的诊断工具。
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