Dourakis S P, Alexopoulou A A, Hadziyannis S J
Academic Department of Medicine, Hippokration General Hospital, Athens, Greece.
J Hepatol. 1994 Mar;20(3):350-3. doi: 10.1016/s0168-8278(94)80006-5.
Two cases of severe acute hepatitis in patients taking flutamide for metastatic prostatic carcinoma are reported. Jaundice and marked increase in aminotransferases occurred after 6-8 weeks of treatment. Continuation of flutamide administration was associated with the development of hepatic encephalopathy and a marked prolongation of prothrombin time. One of the patients died of acute liver failure and the other survived after prolonged hospitalization. Rechallenge was not performed because of the severity of the clinical picture. Liver histology showed extensive hepatic necrosis. These two cases strongly suggest that flutamide, in addition to its cholestatic side effects, can induce acute hepatitis potentially with a fulminant and lethal course. Journal of Hepatology.
报告了两例服用氟他胺治疗转移性前列腺癌的患者发生严重急性肝炎的病例。治疗6 - 8周后出现黄疸和转氨酶显著升高。继续服用氟他胺与肝性脑病的发生及凝血酶原时间显著延长有关。其中一名患者死于急性肝衰竭，另一名患者经长期住院后存活。由于临床表现严重，未进行再次激发试验。肝脏组织学显示广泛的肝坏死。这两例病例强烈提示，氟他胺除了具有胆汁淤积性副作用外，还可诱发急性肝炎，且可能伴有暴发性和致死性病程。《肝脏病学杂志》
