Eser Murat, Basyigit Sebahat, Eser Mithat, Nazligul Yasar
Department of Internal Medicine, Kecioren Research and Training Hospital, Ankara, Turkey.
Department of Gastroenterology, Kecioren Research and Training Hospital, Ankara, Turkey.
Euroasian J Hepatogastroenterol. 2015 Jul-Dec;5(2):134-135. doi: 10.5005/jp-journals-10018-1153. Epub 2016 Jul 9.
Liver is the main organ which can metabolize many drugs or chemical agents. Toxic events developed by drugs are one of the most common causes of liver damage. Toxic hepatitis can be encountered in different clinical situations, such as acute hepatitis, fulminant hepatitis chronic hepatitis or cirrhosis. We aimed to report a case of asymptomatic toxic hepatitis in a patient taking propylthiouracil (PTU). A 38 years old female patient admitted to hospital complained of fatigue. She had no special medical history except Graves' disease. She had been taking PTU 300 mg/day for 1 month. She had no history of another medication, eating mushroom, alcohol consumption, traveling, family history of liver disease. Her physical examination was normal. Laboratory analysis revealed that alanine aminotransferase-543 U/L, aspartate aminotransferase-227 U/L, gamma glutamyl transferase-66 U/L and alkaline phosphatase-136 U/L. Serum levels of bilirubin and albumin, INR, complete blood count and thyroid function tests were all normal. She had normal liver function test (LFT) before using PTU. Propylthiouracil was discontinued and she was given methimazole. She was examined for the etiology of abnormal LFT, but no specific etiology could be recorded. She was thought to have toxic hepatitis related to PTU. In her follow-up LFT has turned to normal level (Table 1).
Eser M, Basyigit S, Eser M, Nazligul Y. Propylthiouracil-related Toxic Hepatitis: Impact of Silent Cases. Euroasian J Hepato-Gastroenterol 2015;5(2):134-135.
肝脏是能够代谢多种药物或化学制剂的主要器官。药物引发的毒性事件是肝损伤最常见的原因之一。毒性肝炎可见于不同的临床情况,如急性肝炎、暴发性肝炎、慢性肝炎或肝硬化。我们旨在报告一例服用丙硫氧嘧啶(PTU)的患者发生无症状毒性肝炎的病例。一名38岁女性患者入院,主诉疲劳。除格雷夫斯病外,她无特殊病史。她服用PTU 300毫克/天,已服用1个月。她无其他用药史、食用蘑菇史、饮酒史、旅行史及肝病家族史。她的体格检查正常。实验室分析显示,丙氨酸转氨酶-543 U/L,天冬氨酸转氨酶-227 U/L,γ-谷氨酰转移酶-66 U/L,碱性磷酸酶-136 U/L。血清胆红素、白蛋白水平、国际标准化比值、全血细胞计数及甲状腺功能检查均正常。她在使用PTU前肝功能检查(LFT)正常。停用丙硫氧嘧啶,给予甲巯咪唑。对其肝功能异常的病因进行检查,但未记录到具体病因。考虑她患有与PTU相关的毒性肝炎。在随访中,其肝功能已恢复正常水平(表1)。
埃塞尔·M、巴西伊吉特·S、埃塞尔·M、纳兹利古尔·Y。丙硫氧嘧啶相关的毒性肝炎:无症状病例的影响。《欧亚肝脏胃肠病学杂志》2015;5(2):134 - 135。