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阿奇霉素诱发的自身免疫特征哮喘加重患者的肝损伤

Azithromycin-Induced Liver Injury in an Asthma Exacerbation Patient With Autoimmune Features.

作者信息

Liang Richard, Ramdass Adesh

机构信息

Medicine, New York Institute of Technology College of Osteopathic Medicine, Glen Head, USA.

Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.

出版信息

Cureus. 2022 May 29;14(5):e25447. doi: 10.7759/cureus.25447. eCollection 2022 May.

DOI:10.7759/cureus.25447
PMID:35774698
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9239290/
Abstract

Drug-induced liver injury (DILI) is one of the leading causes of acute liver failure in the United States. Antimicrobials are the most common class of drugs implicated in this pathology. Although azithromycin has been documented as a relatively safe drug, one of its rare and potentially fatal side effects is DILI. Diagnosing DILI is difficult because it is a diagnosis of exclusion. Autoimmune hepatitis (AIH) may present similarly to DILI, and a liver biopsy may be needed to differentiate between the two conditions. We present a case of azithromycin-induced liver injury in an asthma exacerbation patient with features of AIH.

摘要

药物性肝损伤（DILI）是美国急性肝衰竭的主要原因之一。抗菌药物是与此病理相关的最常见药物类别。尽管阿奇霉素已被证明是一种相对安全的药物，但其罕见且可能致命的副作用之一是DILI。诊断DILI很困难，因为它是一种排除性诊断。自身免疫性肝炎（AIH）可能与DILI表现相似，可能需要进行肝活检以区分这两种情况。我们报告一例哮喘加重患者出现阿奇霉素诱导的肝损伤且伴有AIH特征的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/3d60583a54a8/cureus-0014-00000025447-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/68f709986ba5/cureus-0014-00000025447-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/8faa96cffd04/cureus-0014-00000025447-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/6c187cf357fd/cureus-0014-00000025447-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/9771c59e4d39/cureus-0014-00000025447-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/3d60583a54a8/cureus-0014-00000025447-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/68f709986ba5/cureus-0014-00000025447-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/8faa96cffd04/cureus-0014-00000025447-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/6c187cf357fd/cureus-0014-00000025447-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/9771c59e4d39/cureus-0014-00000025447-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee6/9239290/3d60583a54a8/cureus-0014-00000025447-i05.jpg

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Factors associated with the antinuclear antibody (ANA) titer of systemic autoimmune rheumatic diseases in ANA-positive patients after treatment: a retrospective study.治疗后抗核抗体（ANA）滴度阳性的系统性自身免疫性风湿病患者与 ANA 滴度相关的因素：一项回顾性研究。
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Ototoxicity of Non-aminoglycoside Antibiotics.
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Front Neurol. 2021 Mar 9;12:652674. doi: 10.3389/fneur.2021.652674. eCollection 2021.
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Azithromycin: The First Broad-spectrum Therapeutic.阿奇霉素：第一种广谱治疗药物。
Eur J Med Chem. 2020 Dec 1;207:112739. doi: 10.1016/j.ejmech.2020.112739. Epub 2020 Aug 19.
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Diagnosis and Management of Autoimmune Hepatitis in Adults and Children: 2019 Practice Guidance and Guidelines From the American Association for the Study of Liver Diseases.成人和儿童自身免疫性肝炎的诊断与管理：美国肝病研究协会2019年实践指南与规范
Hepatology. 2020 Aug;72(2):671-722. doi: 10.1002/hep.31065. Epub 2020 May 12.
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United European Gastroenterol J. 2019 Nov;7(9):1156-1163. doi: 10.1177/2050640619872408. Epub 2019 Aug 25.
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Intrahepatic cholestasis of pregnancy or azithromycin-induced intrahepatic cholestasis: A case report.妊娠肝内胆汁淤积症或阿奇霉素诱发的肝内胆汁淤积症：病例报告
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