Kanagalingam Tharsan, Lazarte Julieta, Wong David K H, Hegele Robert A
Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Department Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
CJC Open. 2020 Sep 28;3(2):195-197. doi: 10.1016/j.cjco.2020.09.018. eCollection 2021 Feb.
Statin intolerance, primarily myalgia, is not uncommon in patients treated for elevated low-density lipoprotein cholesterol. Nonstatin drugs, such as ezetimibe, can spare patients from statin exposure, while still reducing low-density lipoprotein cholesterol. Ezetimibe is generally very well tolerated, although gastrointestinal and musculoskeletal symptoms have been occasionally reported. We describe an extremely rare case of an ezetimibe-associated liver injury who required protracted treatment with prednisone and azathioprine. Ezetimibe-associated liver injury should be suspected with development of hepatic abnormalities concurrent with the timing of ezetimibe treatment and in the absence of other possible precipitating factors.
他汀不耐受，主要是肌痛，在接受低密度脂蛋白胆固醇升高治疗的患者中并不少见。非他汀类药物，如依折麦布，可以使患者避免接触他汀类药物，同时仍能降低低密度脂蛋白胆固醇。依折麦布一般耐受性良好，尽管偶尔有胃肠道和肌肉骨骼症状的报告。我们描述了一例极为罕见的依折麦布相关性肝损伤病例，该患者需要长期使用泼尼松和硫唑嘌呤治疗。当出现与依折麦布治疗时间同步的肝脏异常且无其他可能的诱发因素时，应怀疑依折麦布相关性肝损伤。
