Munoz S J, Fariello R, Maddrey W C
Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania 19107.
Dig Dis Sci. 1988 Mar;33(3):375-80. doi: 10.1007/BF01535765.
Progabide, a recently introduced gamma-aminobutyric acid mimetic, is currently undergoing clinical evaluation for a variety of convulsive disorders. We describe a patient in whom severe hepatic failure developed after four weeks of Progabide therapy. The patient's course was marked by encephalopathy, jaundice, hypoglycemia, markedly elevated serum aminotransferase levels, and prolongation of the prothrombin time. Liver biopsy showed extensive hepatocellular necrosis. The patient recovered slowly after discontinuation of the drug. The finding of eosinophilia and increased serum IgE suggests an immunologically mediated mechanism for the Progabide-induced hepatic injury. Alternatively, the lipophilic moiety of Progabide may interact with hepatocyte cell membrane lipids leading to toxic injury. We conclude that Progabide may occasionally cause severe hepatic injury.
普罗加比是一种最近推出的γ-氨基丁酸模拟物，目前正在对多种惊厥性疾病进行临床评估。我们描述了一名患者，其在接受普罗加比治疗四周后出现了严重肝功能衰竭。该患者的病程特点为肝性脑病、黄疸、低血糖、血清转氨酶水平显著升高以及凝血酶原时间延长。肝活检显示广泛的肝细胞坏死。停药后患者恢复缓慢。嗜酸性粒细胞增多和血清IgE升高提示普罗加比诱导的肝损伤存在免疫介导机制。或者，普罗加比的亲脂部分可能与肝细胞膜脂质相互作用导致毒性损伤。我们得出结论，普罗加比偶尔可能会引起严重肝损伤。
