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头孢吡肟所致混合性肝细胞性和胆汁淤积性肝损伤:1例报告

Cefepime-Induced Mixed Hepatocellular and Cholestatic Liver Injury: A Case Report.

作者信息

Toofantabrizi Mahyar, Timshina Anuj, Dongol Raj M

机构信息

Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA.

Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, USA.

出版信息

Cureus. 2024 Nov 10;16(11):e73393. doi: 10.7759/cureus.73393. eCollection 2024 Nov.

Abstract

Drug-induced liver injury (DILI) presents significant diagnostic challenges, particularly in patients with multiple comorbidities. We report a case involving a 72-year-old female treated with cefepime for urosepsis, who developed markedly elevated liver enzymes after two weeks of therapy. After excluding other potential causes, including viral hepatitis, ischemia, and autoimmune hepatitis, cefepime-induced mixed pattern liver injury was determined to be the likely etiology of the elevated liver enzymes. This case underscores the importance of considering DILI in the differential diagnosis and emphasizes the necessity for vigilant monitoring and early recognition, particularly in elderly patients.

摘要

药物性肝损伤(DILI)带来了重大的诊断挑战,尤其是在患有多种合并症的患者中。我们报告了一例病例,一名72岁女性因泌尿道感染接受头孢吡肟治疗,治疗两周后出现肝酶显著升高。在排除其他潜在原因,包括病毒性肝炎、缺血性肝炎和自身免疫性肝炎后,头孢吡肟引起的混合型肝损伤被确定为肝酶升高的可能病因。该病例强调了在鉴别诊断中考虑DILI的重要性,并强调了进行密切监测和早期识别的必要性,尤其是在老年患者中。

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本文引用的文献

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Chronic Drug-Induced Liver Injury: Updates and Future Challenges.慢性药物性肝损伤:最新进展与未来挑战
Front Pharmacol. 2021 Mar 8;12:627133. doi: 10.3389/fphar.2021.627133. eCollection 2021.
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Acute Toxicity and Triphasic Waves-The Example of Cefepime.急性毒性与三相波——以头孢吡肟为例
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Drug-induced liver injury in older people.老年人药物性肝损伤。
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