Roy A K, Mahoney H C, Levine R A
Department of Medicine, State University of New York Health Science Center, Syracuse 13210.
Dig Dis Sci. 1993 Apr;38(4):740-3. doi: 10.1007/BF01316808.
Phenytoin has been associated with acute hepatotoxicity. Chronic liver enzyme abnormalities associated with phenytoin have been attributed to enzyme induction. There have been no reports of phenytoin-induced chronic hepatitis. We describe an asymptomatic 52-year-old woman who received phenytoin sodium for 11 years and was found to have elevated serum aminotransferases. Assays for hepatitis A, B, and C were negative. Liver biopsy was performed and showed chronic persistent hepatitis. This documentation of phenytoin-induced chronic persistent hepatitis was proven by histology and its etiology confirmed by drug withdrawal and by rechallenge. Although uncommon, this entity is important to recognize in the differential diagnosis of asymptomatic chronic hepatic enzyme dysfunction.
苯妥英钠与急性肝毒性有关。与苯妥英钠相关的慢性肝酶异常归因于酶诱导作用。此前尚无苯妥英钠诱发慢性肝炎的报道。我们报告一例无症状的52岁女性，其服用苯妥英钠11年，发现血清转氨酶升高。甲型、乙型和丙型肝炎检测均为阴性。进行了肝活检，结果显示为慢性持续性肝炎。苯妥英钠诱发慢性持续性肝炎的诊断通过组织学得到证实，其病因通过停药及再次用药激发试验得以确认。尽管这种情况不常见，但在无症状慢性肝酶功能障碍的鉴别诊断中认识到这一实体很重要。
