Department of Internal Medicine and Geriatrics, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Department of Internal Medicine and Geriatrics, Cleveland Clinic Foundation, Cleveland, Ohio, USA
BMJ Case Rep. 2021 Aug 17;14(8):e243278. doi: 10.1136/bcr-2021-243278.
Hydralazine is a commonly prescribed antihypertensive agent. Some of its labelled adverse reactions include lupus-like syndrome, tachycardia, headache and fever. Despite its well-known side effects, little is known about hydralazine's hepatotoxic effects. We report the case of a 54-year-old female patient who was started on hydralazine for hypertension management but later presented with hydralazine-induced liver injury. Her initial presentation consisted of non-specific symptoms and a hepatocellular injury pattern. Liver biopsy revealed hepatic steatosis. Three weeks after discontinuation of hydralazine, the patient's liver enzymes normalised, and her symptoms resolved. Few studies have examined the incidence and mechanism by which hydralazine induces a liver injury pattern. With this case, we review the literature, the pathogenesis involved and the eventual management of hydralazine-induced liver injury. We propose close monitoring of liver enzymes for patients on hydralazine throughout their treatment course.
肼屈嗪是一种常用的降压药物。其一些已知的不良反应包括狼疮样综合征、心动过速、头痛和发热。尽管肼屈嗪有众所周知的副作用，但对其肝毒性作用知之甚少。我们报告了一例 54 岁女性患者的病例，该患者因高血压接受肼屈嗪治疗，但后来出现肼屈嗪引起的肝损伤。她最初的表现为非特异性症状和肝细胞损伤模式。肝活检显示肝脂肪变性。肼屈嗪停用 3 周后，患者的肝酶正常化，症状缓解。很少有研究探讨肼屈嗪引起肝损伤模式的发生率和机制。通过这个病例，我们回顾了文献，探讨了相关发病机制以及肼屈嗪引起的肝损伤的最终治疗方法。我们建议在治疗过程中密切监测接受肼屈嗪治疗的患者的肝酶。
