普罗帕酮所致胆汁淤积性肝损伤：诊断时需分秒必争。
Propafenone-Induced Cholestatic Liver Injury: When Diagnosis Does Not Skip a Beat.
作者信息
Ferreira Ana Isabel, Macedo Silva Vítor, Arieira Cátia, Xavier Sofia, Magalhães Joana, Cotter José
机构信息
Gastroenterology Department, Unidade Local de Saúde do Alto Ave, Guimarães, Portugal.
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
出版信息
GE Port J Gastroenterol. 2024 Oct 18;32(3):212-220. doi: 10.1159/000541557. eCollection 2025 Jun.
INTRODUCTION
Propafenone is a widely used class Ic antiarrhythmic drug that is mainly metabolised by the liver. Hepatotoxicity associated with propafenone is rare, with only a few clinical cases reported in the literature.
CASE PRESENTATION
We presented a case of propafenone-related hepatotoxicity, with cholestatic liver injury and development of jaundice and pruritus within 3 to 4 weeks of treatment initiation. Three months after discontinuation, the patient was asymptomatic, and all liver tests normalised.
CONCLUSION
With this clinical case, we aimed to emphasise the importance of the medication history and the exclusion of other possible causes of altered liver enzymes.
引言
普罗帕酮是一种广泛使用的Ic类抗心律失常药物，主要经肝脏代谢。与普罗帕酮相关的肝毒性罕见，文献中仅报道了少数临床病例。
病例报告
我们报告了一例普罗帕酮相关肝毒性病例，在开始治疗后3至4周内出现胆汁淤积性肝损伤，并伴有黄疸和瘙痒。停药三个月后，患者无症状，所有肝功能检查均恢复正常。
结论
通过这个临床病例，我们旨在强调用药史的重要性以及排除其他可能导致肝酶改变的原因。
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