Shiloah E, Horowiz M, Zecler E
Dept. of Medicine C, Assaf Harofeh Medical Center, Zerifin.
Harefuah. 1997 Jul;133(1-2):11-2, 80-1.
A 43-year-old man presented with weakness, pruritus, skin rash and jaundice 2 weeks after treatment for onychomycosis with terbinafine (Lamisil) was started. Liver function tests showed combined hepatocellular and cholestatic injury. Ultrasound examination, computerized tomography and ERCP excluded extrahepatic obstruction. Serology was negative for HBV, HCV, HAV, CMV, and EBV. Liver biopsy was consistent with drug-induced cholestatic injury. Since the clinical picture did not improve when terbinafine was stopped, corticosteroids were started and resulted in complete clinical and laboratory recovery; liver function tests were normal 8 months after corticosteroids were discontinued.
一名43岁男性在开始使用特比萘芬（兰美抒）治疗甲癣2周后，出现乏力、瘙痒、皮疹和黄疸。肝功能检查显示肝细胞和胆汁淤积性联合损伤。超声检查、计算机断层扫描和内镜逆行胰胆管造影排除了肝外梗阻。乙肝、丙肝、甲肝、巨细胞病毒和EB病毒血清学检查均为阴性。肝活检结果符合药物性胆汁淤积性损伤。停用特比萘芬后临床症状未改善，遂开始使用皮质类固醇，最终临床和实验室检查完全恢复；停用皮质类固醇8个月后肝功能检查正常。
