Baba M, Shima T, Tanaka T, Nakayabu M, Hasegawa H, Suzuki S, Kusano I
Third Department of Internal Medicine, Mie University School of Medicine, Japan.
J Gastroenterol. 1994 Feb;29(1):88-92. doi: 10.1007/BF01229081.
A 51-year-old woman constitutionally susceptible to allergy presented with acute allergic liver injury. She was taking tegafur for treatment of carcinoma of the uterus. The acute liver injury appeared 3 weeks after the first drug administration. She had marked elevation of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT), moderate jaundice, and eosinophilia. The virus markers revealed hepatitis B surface antigen (HBsAg) (-) antibody to hepatitis B surface antigen (HBsAb) (+), and immunoglobulin M HA antibody (IgM HA Ab) (-). The laparoscopic and histologic findings were compatible with drug-induced liver injury. Further, the results of the lymphocyte stimulation test (LST) and challenge test by tegafur were positive. From the above findings, the liver injury was diagnosed to be an allergic reaction induced by tegafur. The hepatic function returned to normal about 20 days after tegafur administration was suspended. Allergic liver injury induced by tegafur is very rare. We report the case with a short review of the literature.
一名51岁、体质易过敏的女性出现急性过敏性肝损伤。她正在服用替加氟治疗子宫癌。急性肝损伤在首次用药3周后出现。她的谷草转氨酶（GOT）和谷丙转氨酶（GPT）显著升高，有中度黄疸和嗜酸性粒细胞增多。病毒标志物显示乙肝表面抗原（HBsAg）（-）、乙肝表面抗体（HBsAb）（+）以及免疫球蛋白M型HA抗体（IgM HA Ab）（-）。腹腔镜检查和组织学检查结果与药物性肝损伤相符。此外，替加氟淋巴细胞刺激试验（LST）和激发试验结果呈阳性。根据上述结果，肝损伤被诊断为由替加氟引起的过敏反应。停用替加氟约20天后肝功能恢复正常。替加氟引起的过敏性肝损伤非常罕见。我们报告该病例并对相关文献进行简要回顾。
