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在对其他类型血管紧张素II受体阻滞剂无不良反应的患者中,非马沙坦引起的肝损伤:一例报告。

Fimasartan-induced liver injury in a patient with no adverse reactions on other types of angiotensin II receptor blockers: A case report.

作者信息

Park Dae Hwa, Yun Gee Young, Eun Hyuk Soo, Joo Jong Seok, Kim Ju Seok, Kang Sun Hyung, Moon Hee Seok, Lee Eaum Seok, Lee Byung Seok, Kim Kyung Hee, Kim Seok Hyun

机构信息

Department of Internal Medicine Department of Pathology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea.

出版信息

Medicine (Baltimore). 2017 Nov;96(47):e8905. doi: 10.1097/MD.0000000000008905.

Abstract

RATIONALE

Angiotensin II receptor blockers (ARBs) are widely used for patients with hypertension, and fimasartan is a recently approved ARBs. Fimasartan can cause headache, dizziness, itching, and coughing. There have been several reports of hepatotoxicity in ARBs. However, there have not yet been published reports of the hepatotoxicity of fimasartan.

PATIENT CONCERNS

A 73-year-old man with hypertension experienced liver injury after fimasartan administration. He had a previous history of taking 3 types of ARBs each for more than 2 years before taking fimasartan, and there were no side effects on ARBs except for fimasartan.

DIAGNOSES

Other factors that could cause liver injury were excluded in diagnostic tests, and fimasartan was suspected to be the causative agent.

INTERVENTION

Fimasartan was immediately discontinued and the patient was managed with supportive care via hepatotonics.

DIAGNOSES

Other factors that could cause liver injury were excluded in diagnostic tests, and fimasartan was suspected to be the causative agent.

OUTCOME

The liver injury due to fimasartan was confirmed by histology and accidental redosing.

LESSONS

We emphasize that liver function should be monitored during fimasartan administration because fimasartan may cause hepatotoxicity in patients who have no side effects with other types of ARBs. And fimasartan-induced liver injury may appear later than other ARBs.

摘要

理论依据

血管紧张素II受体阻滞剂(ARBs)广泛应用于高血压患者,菲马沙坦是最近获批的ARBs。菲马沙坦可引起头痛、头晕、瘙痒和咳嗽。已有数篇关于ARBs肝毒性的报道。然而,尚未有关于菲马沙坦肝毒性的报道发表。

患者情况

一名73岁高血压男性在服用菲马沙坦后出现肝损伤。在服用菲马沙坦之前,他曾有过服用3种ARBs每种超过2年的病史,除菲马沙坦外,服用ARBs均无副作用。

诊断

诊断检查排除了其他可能导致肝损伤的因素,怀疑菲马沙坦是致病因素。

干预措施

立即停用菲马沙坦,并通过保肝药物对患者进行支持治疗。

诊断

诊断检查排除了其他可能导致肝损伤的因素,怀疑菲马沙坦是致病因素。

结果

通过组织学检查和意外再次给药证实了菲马沙坦所致的肝损伤。

经验教训

我们强调,在服用菲马沙坦期间应监测肝功能,因为菲马沙坦可能会在对其他类型ARBs无副作用的患者中引起肝毒性。而且菲马沙坦所致肝损伤可能比其他ARBs出现得更晚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ff/5709023/c211785eed35/medi-96-e8905-g001.jpg

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