Adcock K G, MacElroy D E, Wolford E T, Farrington E A
University of North Carolina Hospitals and Clinics, Chapel Hill 27514, USA.
Ann Pharmacother. 1998 Apr;32(4):422-5. doi: 10.1345/aph.17279.
To describe a case of pemoline-induced liver failure resulting in liver transplantation.
A 9-year-old white boy, diagnosed with attention deficit/hyperactivity disorder (ADHD) and treated with pemoline, developed signs and symptoms of liver failure. Pemoline therapy was discontinued, but the patient's liver function continued to decline. Ultimately, a liver transplantation was required.
Pemoline, an agent used in ADHD treatment, has been associated with hepatotoxicity with the majority of cases occurring in pediatric patients. To our knowledge, this is the second reported case of pemoline-induced liver failure resulting in liver transplantation. The mechanism of action remains unclear, with several hypotheses being postulated including hypersensitivity reactions, dose-related phenomena, and autoimmune-mediated reactions.
With increasing evidence linking pemoline to liver failure, this agent should not be considered first-line therapy for ADHD. Prior to initiating therapy, baseline liver function tests should be obtained and closely monitored, and parents and patients should be educated on the signs and symptoms of liver toxicity.
描述一例因匹莫林导致肝衰竭并接受肝移植的病例。
一名9岁白人男孩，被诊断为注意力缺陷多动障碍（ADHD）并接受匹莫林治疗，出现了肝衰竭的体征和症状。停用了匹莫林治疗，但患者的肝功能仍持续下降。最终，需要进行肝移植。
匹莫林是一种用于治疗ADHD的药物，已被发现与肝毒性有关，大多数病例发生在儿科患者中。据我们所知，这是第二例报道的因匹莫林导致肝衰竭并接受肝移植的病例。其作用机制仍不清楚，有几种假说被提出，包括过敏反应、剂量相关现象和自身免疫介导的反应。
随着越来越多的证据表明匹莫林与肝衰竭有关，该药物不应被视为ADHD的一线治疗药物。在开始治疗前，应进行基线肝功能检查并密切监测，同时应向家长和患者进行肝毒性体征和症状的教育。
