Purdum P P, Shelden S L, Boyd J W, Shiffman M L
Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond.
Ann Pharmacother. 1994 Oct;28(10):1159-61. doi: 10.1177/106002809402801004.
To report oxaprozin-induced fulminant hepatic failure.
A 56-year-old woman was admitted with fulminant hepatic failure. Work-up for potential etiologies was negative except for the use of oxaprozin for the preceding two months. Results of premortem liver biopsy were consistent with drug-induced hepatic injury similar to that previously reported with diclofenac.
Although the literature describes elevation in hepatic transaminase concentrations associated with oxaprozin, fulminant hepatic failure has not been described previously.
Elevations in hepatic transaminase concentrations and now fulminant hepatic failure have been shown to occur with oxaprozin, as previously seen with other nonsteroidal antiinflammatory drugs (NSAIDs). Transaminitis is a known adverse effect of NSAID use, but is usually mild and reversible with discontinuation of drug. Transaminitis may be more likely to occur in the elderly, in patients receiving concurrent potentially hepatotoxic medications, and possibly with the newer long-acting NSAIDs. The existence of fulminant hepatitis, although rare, supports the need for monitoring liver function enzymes during NSAID therapy.
报告恶丙嗪引起的暴发性肝衰竭。
一名56岁女性因暴发性肝衰竭入院。除了在之前两个月使用恶丙嗪外，对潜在病因的检查均为阴性。死前肝活检结果与药物性肝损伤一致，类似于先前报道的双氯芬酸所致的肝损伤。
虽然文献描述了与恶丙嗪相关的肝转氨酶浓度升高，但此前尚未有暴发性肝衰竭的报道。
已证实恶丙嗪可导致肝转氨酶浓度升高以及现在的暴发性肝衰竭，正如之前其他非甾体抗炎药（NSAIDs）所出现的情况一样。转氨酶升高是使用NSAIDs已知的不良反应，但通常较轻，停药后可逆转。转氨酶升高在老年人、同时接受可能具有肝毒性药物治疗的患者中以及可能在使用新型长效NSAIDs时更易发生。暴发性肝炎虽然罕见，但其存在支持在NSAID治疗期间监测肝功能酶的必要性。
