吗替麦考酚酯分散片致药物性肝损伤1例分析

One Case of Liver Injury Induced by Mycophenolate Mofetil Dispersible Tablets

目的分析吗替麦考酚酯分散片致药物性肝损伤的不良反应特点。方法总结上海仁济医院2019年12月收治的1例服用吗替麦考酚酯后出现肝酶升高不良反应的病例。结果患者进行性视力下降2月余,诊断视神经脊髓炎谱系疾病,服用吗替麦考酚酯分散片(0.25 g/d)后5天中出现肝酶逐渐升高,最高时谷丙转氨酶(ALT)350 U/L、谷草转氨酶(AST)161 U/L,乳酸脱氢酶(LDH)126 U/L,碱性磷酸酶(ALP)63 U/L,γ-L-谷氨酰转肽酶(γ-GT)25 U/L。停用吗替麦考酚酯后,给予保肝治疗。5天后复查,肝功能正常。结论吗替麦考酚酯分散片可致药物性肝损伤的不良反应,应加强其用药监测。

Objective To analyze such adverse effects of mycophenolate mofetil dispersible tablets as drug-induced liver injury.Methods The clinical data on one case of elevation of hepatic enzymes after taking mycophenolate mofetil dispersible tablets in Shanghai Renji Hospital in December 2019 was summarized.Results The patient complained about progressive vision loss of more than 2 months.She was diagnosed with neuromyelitis optica spectrum disorders.Hepatic enzymes gradually increased 5 days after taking mycophenolate mofetil dispersible tablets(0.25 g/d).The peak value was 350 U/L for alanine aminotransferase(ALT),161 U/L for aspartate aminotransferase(AST),126 U/L for lactate dehydrogenase(LDH),63 U/L for alkaline phosphatase(ALP),and 25 U/L forγ-Lglutamyltranspeptidase(γ-GT).After mycophenolate mofetil dispersible tablets were discontinued,hepatoprotective treatment was given.During the revisit 5 days later,her hepatic function returned to normal.Conclusion Mycophenolate mofetil has adverse effects,such as drug-induced liver injury.