孟鲁司特致药物性肝炎

Drug-induced hepatitis following montelukast

1例74岁男性患者因过敏性鼻炎、过敏性咽喉炎口服孟鲁司特及氯雷他定治疗。患者既往无药物过敏史及慢性肝病史。连续服药5 d后,患者出现皮肤黄染、恶心、纳差。肝功能:ALT 670 IU.L-1,AST 594 IU.L-1,T-BIL 79.1μmol.L-1,D-BIL 42.06μmol.L-1,TBA 5.8μmol.L-1。入院后行肝穿刺病理检查提示肝小叶内点片状坏死,汇管区嗜酸性粒细胞浸润,符合药物性肝炎的诊断标准。停用可疑药物,给予复方甘草酸苷、还原型谷胱甘肽、维生素C、茵栀黄口服液等治疗,肝功能逐渐恢复。出院2个月后血生化恢复正常。

One 74-year-old man received montelukast and loratadine for the treatment of allergic rhinitis and allergic pharyngolaryngitis.The patient had no history of drug allergy or chronic hepatic disease.After fi ve days,the patient developed skin stained yellow,nausea and anorexia.The liver function examination showed the following values： ALT 670 IU.L-1,AST 594 IU.L-1,T-BIL 79.1 μmol.L-1,D-BIL 42.6 μmol.L-1,TBA 5.8 μmol.L-1.Pathology examination showed patchy necrosis within hepatic lobule and portal area infi ltrated by eosinophile granulocyte through liver biopsy.The symptoms met the diagnosis criteria for drug-induced hepatitis.After stopping the suspected drugs,the patient was administered with compound glycyrrhizin injection,reduced glutathione injection,vitamin C injection and Yinzhihuang oral solution.The liver function of this patient gradually recovered.The biochemistry results were normal 2 months after his discharging from hospital.