成功应用皮质类固醇治疗因中草药“Mega Defends X”导致的严重肝损伤：采用改良后的 RUCAM 评估因果关系的病例报告。
Successful corticosteroid therapy for severe liver injury secondary to herbal traditional Chinese medicine, Mega Defends X, assessed for causality by the updated RUCAM: A case report.
机构信息
Department of Gastroenterology, Liver Cirrhosis Study Group, General Hospital of Northern Theater Command (Teaching Hospital of Shenyang Pharmaceutical University), Shenyang, China.
Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Hanau, Germany.
出版信息
Medicine (Baltimore). 2024 Aug 23;103(34):e39439. doi: 10.1097/MD.0000000000039439.
RATIONALE
In China, herbal traditional Chinese medicine products are readily obtained without any requirement of prescription and widely used in real life, thereby increasing the incidence of their related herb-induced liver injury (HILI). However, the diagnosis of HILI is still challenging because its clinical manifestations are variable due to lack of any specific biomarkers. Misdiagnosis and inappropriate treatment may result in the progression of HILI.
PATIENT CONCERNS
A 55-year-old female patient was admitted to the hospital due to progressive jaundice.
DIAGNOSES
The diagnoses of HILI secondary to Mega Defends X, an herbal traditional Chinese medicine product, for which the score was 9 based on the updated Roussel Uclaf Causality Assessment Method of 2016.
INTERVENTIONS
The patient received corticosteroid with a stepwise dosage reduction.
OUTCOMES
The liver injury significantly improved by corticosteroid treatment.
LESSONS
Corticosteroids should be potentially effective and safe in patients with severe HILI.
背景
在中国，草药类中药产品无需处方即可轻易获得，在现实生活中广泛使用，从而增加了与草药相关的肝损伤（HILI）的发病率。然而，由于缺乏任何特定的生物标志物，HILI 的诊断仍然具有挑战性。误诊和不适当的治疗可能导致 HILI 的进展。
患者关注
一名 55 岁女性患者因进行性黄疸入院。
诊断
根据 2016 年更新的 Roussel Uclaf Causality Assessment Method（RUCAM），诊断为草药类中药产品“美格菲”引起的 HILI，评分 9 分。
干预措施
患者接受了逐步递减剂量的皮质类固醇治疗。
结果
肝损伤经皮质类固醇治疗后显著改善。
经验教训
皮质类固醇可能对严重 HILI 患者有效且安全。
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