Park Hyun Joon, Seo Kwang Il, Choi Young Il
Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
Korean J Transplant. 2020 Dec 31;34(4):279-285. doi: 10.4285/kjt.20.0017. Epub 2020 Nov 11.
Drug-induced liver injury is the most common cause of acute liver failure in Western countries by prescription drugs and herbal medications. Liver injury due to azithromycin has rarely been reported. This is a brief report of a patient administered azithromycin and who developed acute liver failure leading to liver transplantation. We report the case of a 68-year-old woman who developed jaundice 1 week after she started taking a azithromycin. On the 3rd day of hospitalization, her hepatic function rapidly deteriorated and level of consciousness decreased to drowsiness. The model for end-stage liver disease score was confirmed to be 33, and liver transplantation was considered. On the 8th day of hospitalization, she underwent emergency living donor liver transplantation, receiving a right lobe liver graft from a 35-year-old male donor, the patient's son. Currently, she is alive with good liver function after 25 months of transplant. This case suggests that azithromycin may cause rare hepatitis with liver failure. Therefore, at the beginning of the azithromycin treatment, patients should visit the hospital immediately if symptoms such as jaundice and abdominal pain are experienced.
药物性肝损伤是西方国家由处方药和草药导致急性肝衰竭的最常见原因。阿奇霉素所致肝损伤鲜有报道。本文简要报告了一例使用阿奇霉素后发生急性肝衰竭并接受肝移植的患者。我们报告了一名68岁女性的病例，她在开始服用阿奇霉素1周后出现黄疸。住院第3天，其肝功能迅速恶化，意识水平降至嗜睡。终末期肝病模型评分被确认为33分，遂考虑进行肝移植。住院第8天，她接受了紧急活体供肝肝移植，接受了来自一名35岁男性供体（患者的儿子）的右叶肝移植。目前，移植25个月后她存活且肝功能良好。该病例提示阿奇霉素可能导致罕见的伴有肝衰竭的肝炎。因此，在阿奇霉素治疗开始时，如果出现黄疸和腹痛等症状，患者应立即就医。
