别嘌醇致肝损伤2例

Liver injury due to allopurinol:two case reports

2例患者(例1男性,32岁;例2女性,27岁),应用抗结核药物治疗期间肝功能均正常,因尿酸水平升高加用别嘌醇0.1 g,3次/d口服。2周后出现发热、皮疹。实验室检查:例1丙氨酸转氨酶(ALT)1182 U/L,天冬氨酸转氨酶(AST)595 U/L,总胆红素25.9 mmol/L;例2 ALT 1452 U/L,AST 1942 U/L。停用别嘌醇及抗结核药,接受保肝治疗。2例患者肝功能分别于治疗后14、25 d后基本恢复正常。例1继续抗结核治疗,随访4个月肝功能正常。例2因病情稳定停止抗结核治疗。

Two patients, a 32-year-old man and a 27-year-old woman, had normal liver function during antituberculous treatment. Oral allopurinol 0. 1 g thrice daily was added to their regimen due to hyperuricemia. They developed fever and rash after 2 weeks. Laboratory tests showed the following values ： alanine transaminase （ALT） 1182 U/L, aspartate transaminase （AST） 595 U/L, total bilimbin 25. 9 mmol/L in patient 1 ; ALT 1452 U/L, AST 1942 U/L in patient 2. Allopurinol and the antituberculous drugs were discontinued. Both patients received liver-protective treatment. The results of their liver function tests basically returned to normal on days 14 and 25 of treatment, respectively. In patient 1 antituberculous treatment was continued, he had the normal liver function during 4 months of follow-up. In patient 2 antitubereulous treatment was stopped because of the stable condition.