Mascherona Ilenia, Maggioli Caterina, Biggiogero Maira, Mora Oreste, Marelli Lucia
Ospedale La Carità, Medicina Interna, Locarno, Switzerland.
AUSL di Bologna, Ospedale di Budrio, Bologna, Italy.
Case Reports Hepatol. 2020 Oct 1;2020:8812983. doi: 10.1155/2020/8812983. eCollection 2020.
Gemcitabine is an antineoplastic drug used in several forms of advanced pancreatic, lung, breast, ovarian, and bladder cancer. Common side effects include bone marrow suppression, fatigue, diarrhea, nausea, gastrointestinal upset, rash, alopecia, and stomatitis. Transient serum enzyme elevations could be observed during therapy, but clinically significant acute liver injury has been rarely associated with its use. Few cases of acute liver injury have been reported in the literature. We reported the clinical case of a 73--year-old man who developed clinically significant acute hepatic injury after using gemcitabine. Possible causes, clinical presentation, and treatments are discussed. According to the updated RUCAM score, the case was rated 10 points and became a suspected drug-induced liver injury. Moreover, on the liver biopsy, there were histological findings of mild-to-moderate portal hepatitis, eosinophilia, bile duct injury, and mild perisinusoidal fibrosis, suggesting drug damage.
吉西他滨是一种抗肿瘤药物，用于治疗多种晚期胰腺癌、肺癌、乳腺癌、卵巢癌和膀胱癌。常见副作用包括骨髓抑制、疲劳、腹泻、恶心、胃肠道不适、皮疹、脱发和口腔炎。治疗期间可观察到短暂的血清酶升高，但临床上显著的急性肝损伤与其使用很少相关。文献中报道的急性肝损伤病例很少。我们报告了一例73岁男性在使用吉西他滨后发生临床上显著的急性肝损伤的临床病例。讨论了可能的病因、临床表现和治疗方法。根据更新后的RUCAM评分，该病例评分为10分，成为疑似药物性肝损伤。此外，肝脏活检显示有轻度至中度门脉性肝炎、嗜酸性粒细胞增多、胆管损伤和轻度窦周纤维化的组织学表现，提示药物损伤。
