白癜风丸致重度肝损伤1例

A case of severe liver injury caused by Baidianfeng pills

1例10岁男性患儿,因白癜风服用驱白巴布期片近3个月,期间肝功能指标无异常,后更换为白癜风丸,服药13 d后出现目黄、尿黄,恶心、呕吐等症状。入院前检查结果显示:ALT 497.8 U·L^-1,AST 396.0 U·L^-1,TBil 316.3μmol·L^-1,DBil98.46μmol·L^-1,门诊以"肝损害原因待查"收入院。入院后排除病毒性肝炎和自身免疫性肝炎等病因,高度怀疑药物性肝损伤。经因果关系评价,白癜风丸判断为可疑药物。立即停用,并给予注射用还原型谷胱甘肽、复方甘草酸苷注射液和丁二磺酸腺苷蛋氨酸注射剂等进行保肝、退黄、对症支持治疗。经积极治疗,10 d后患儿肝功能指标明显改善,准予出院,并继续口服保肝药物进行序贯治疗。

A 10-year-old male child was diagnosed with vitiligo and started medication treatment.He had taken Qubai Babuqi tablets for nearly 3 months with normal liver function.Then Qubai Babuqi tablets were replaced by Baidianfeng pills and he developed yellow eyes,dark urine,nausea and vomiting 13 days later.Lab results before admission were as follows:ALT 497.8 U·L^-1,AST 396.0 U·L^-1,TBil 316.3μmol·L^-1,DBil 98.46μmol·L^-1.After admission,drug-induced liver injury was considered after excluding other etiology including viral hepatitis and autoimmune hepatitis.The relevance evaluation of Baidianfeng pills and the liver injury was probable.Baidianfeng pills was stopped immediately after admission.And symptomatic supportive treatment including glutathione,compound glycyrrhizin injection and adenosylmethionine succinate injection were given to him for recovery of liver funtion.10 days later,his liver function was significantly improved and he was discharged with oral hepatic-protective drugs.