胺碘酮所致可逆性和不可逆性肝毒性：两例报告
Amiodarone-induced reversible and irreversible hepatotoxicity: two case reports.
作者信息
Tsuda Toyonobu, Tada Hayato, Tanaka Yoshihiro, Nishida Naoto, Yoshida Taiji, Sawada Takeshi, Sakata Kenji, Hayashi Kenshi, Kawashiri Masa-Aki, Oyama Takeru, Sasaki Motoko, Kurose Nozomu, Yamagishi Masakazu
机构信息
Division of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
Department of Molecular and Cellular Pathology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
出版信息
J Med Case Rep. 2018 Apr 14;12(1):95. doi: 10.1186/s13256-018-1629-8.
BACKGROUND
Amiodarone is a highly effective treatment for supraventricular and ventricular tachyarrhythmia; however, it could be associated with several serious adverse effects, including liver injury.
CASE PRESENTATION
We report the clinical and histological features of two contrasting Japanese patients with amiodarone-induced reversible and irreversible hepatotoxicity. One patient with amiodarone-induced irreversible hepatotoxicity showed liver cirrhosis during treatment with amiodarone and died of hepatic failure; the other patient, who had reversible hepatotoxicity, showed a reversible course of liver function and imaging after discontinuation of amiodarone.
CONCLUSIONS
We emphasize the importance of close monitoring of liver enzymes and evaluation of liver computed tomographic imaging as well as liver biopsy during treatment with amiodarone, and discontinuation should be considered when amiodarone-induced hepatotoxicity is suspected.
背景
胺碘酮是治疗室上性和室性快速心律失常的高效药物；然而，它可能会引发多种严重不良反应，包括肝损伤。
病例报告
我们报告了两名日本患者的临床和组织学特征，这两名患者分别出现了胺碘酮所致的可逆性和不可逆性肝毒性。一名胺碘酮所致不可逆性肝毒性患者在胺碘酮治疗期间出现肝硬化并死于肝衰竭；另一名具有可逆性肝毒性的患者在停用胺碘酮后肝功能和影像学表现呈可逆过程。
结论
我们强调在胺碘酮治疗期间密切监测肝酶、评估肝脏计算机断层扫描成像以及进行肝活检的重要性，当怀疑出现胺碘酮所致肝毒性时应考虑停药。
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