Rather Jawad Iqbal, Maqsood Wani Muzafar, Lone Khalid Bin Mushtaq, Rasheed Rabiya
Nephrology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, IND.
Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, IND.
Cureus. 2023 Jun 12;15(6):e40300. doi: 10.7759/cureus.40300. eCollection 2023 Jun.
Norethisterone, a commonly used oral contraceptive, and treatment for various gynecological disorders such as menorrhagia, abnormal uterine bleeding, and breast cancer, has been associated with multiple liver injuries. These injuries can manifest as hepatitis or cholestatic types of injury, benign neoplasms, peliosis hepatis, sinusoidal obstruction syndrome, and enlargement of existing hemangiomas. This report presents three cases in which liver enzyme levels were elevated due to norethisterone intake. Two of the cases were individuals undergoing evaluation as potential kidney donors in the nephrology department for their spouses, while the third case involved a patient with chronic kidney disease (CKD) stage-5 on maintenance hemodialysis. Regular follow-up of these patients, particularly due to the significance of two being kidney donors and one having advanced CKD, allowed for early detection of asymptomatic liver enzyme elevation and prompt discontinuation of norethisterone. Prescribing norethisterone is common in gynecological settings, including ours. To assess gynecologists' knowledge regarding norethisterone-related side effects, we conducted an online survey, the results of which are discussed in this report.
炔诺酮是一种常用的口服避孕药，也用于治疗各种妇科疾病，如月经过多、子宫异常出血和乳腺癌，但它与多种肝损伤有关。这些损伤可表现为肝炎或胆汁淤积型损伤、良性肿瘤、肝紫癜、肝窦阻塞综合征以及现有血管瘤增大。本报告介绍了三例因服用炔诺酮导致肝酶水平升高的病例。其中两例是在肾病科作为潜在肾脏供体为其配偶进行评估的个体，而第三例是一名接受维持性血液透析的慢性肾脏病（CKD）5期患者。对这些患者进行定期随访，特别是鉴于其中两人是肾脏供体且一人患有晚期CKD的重要性，使得能够早期发现无症状的肝酶升高并及时停用炔诺酮。在包括我们科室在内的妇科环境中，开具炔诺酮是很常见的。为了评估妇科医生对炔诺酮相关副作用的了解情况，我们进行了一项在线调查，本报告将讨论其结果。
