Horowitz S, Patwardhan R, Marcus E
Department of Neurology, St. Vincents Hospital, University of Massachusetts Medical School, Worcester 01604.
Epilepsia. 1988 Mar-Apr;29(2):149-54. doi: 10.1111/j.1528-1157.1988.tb04411.x.
Hepatotoxic reactions in patients receiving carbamazepine (CBZ) therapy have been reported, and some have been considered fatal. We present two patients with hepatic dysfunction secondary to CBZ therapy. Liver biopsies were compatible with hepatotoxic damage, and the symptoms were reversible with medication withdrawal. Our patients are representative of those in the literature, most of whom have granulomatous hepatitis and sometimes have associated cholangitis. The patients with fatal reactions differed clinically and pathologically from the others, and may represent a different entity. The clinical syndrome resembles a viral hepatitis. Elderly patients seem to be particularly susceptible and their hepatic function should be monitored closely when CBZ therapy is initiated.
接受卡马西平（CBZ）治疗的患者中已报告有肝毒性反应，其中一些被认为是致命的。我们报告了两名继发于CBZ治疗的肝功能障碍患者。肝活检结果与肝毒性损伤相符，停药后症状可逆。我们的患者与文献中的患者具有代表性，他们大多患有肉芽肿性肝炎，有时伴有胆管炎。发生致命反应的患者在临床和病理上与其他患者不同，可能代表一种不同的疾病实体。临床综合征类似于病毒性肝炎。老年患者似乎特别易感，开始CBZ治疗时应密切监测其肝功能。
