Roenigk H H
Department of Dermatology, Northwestern University Medical School, Chicago, IL 60611.
J Am Acad Dermatol. 1988 Jul;19(1 Pt 2):199-208. doi: 10.1016/s0190-9622(88)70165-6.
Vitamin A metabolism involves storage in the liver. Hypervitaminosis A results in liver abnormalities, including fibrosis and cirrhosis. Ito cells are increased and promote fibrogenesis, which results in cirrhosis. Retinoids (Accutane and Tegison) are used clinically for the treatment of a variety of skin diseases. Since retinoids are analogs of vitamin A, their potential to produce liver disease is reviewed. Animal and human studies of liver function tests suggest some abnormalities in the liver in about 25% of patients treated. Liver biopsy studies have included isolated case reports and two retrospective and one prospective liver biopsy study of retinoids in humans. Although some increase in histologic liver changes have been noted, most liver biopsy specimens showed no change or improvement. Retinoids do not appear to produce consistent toxic liver abnormalities.
维生素A代谢涉及在肝脏中的储存。维生素A过多症会导致肝脏异常，包括纤维化和肝硬化。肝星状细胞增多并促进纤维生成，进而导致肝硬化。维甲酸（异维甲酸和银屑灵）临床上用于治疗多种皮肤病。由于维甲酸是维生素A的类似物，因此对其引发肝病的可能性进行了综述。关于肝功能测试的动物和人体研究表明，在接受治疗的患者中约25%的人肝脏出现了一些异常。肝活检研究包括个别病例报告以及两项关于人类维甲酸的回顾性和一项前瞻性肝活检研究。尽管已注意到肝脏组织学变化有所增加，但大多数肝活检标本未显示变化或有所改善。维甲酸似乎不会产生一致的毒性肝脏异常。
