奥美拉唑致泌乳1例

A case of lactation induced by omeprazole

1例15岁女性患者,因“癫痫持续状态”收入我院,入院后患者脑脊液自身免疫性抗体化验显示抗NMDAR抗体滴度1:100,诊断为抗NMDAR脑炎,给予甲泼尼龙(1 g·d^(-1))冲击治疗,同时给予患者奥美拉唑肠溶胶囊(20 mg,bid,鼻饲)预防大剂量激素所致的应激性溃疡。入院第9天患者双乳有泌乳现象,月经周期仅2d且量少,查泌乳素36.69 ng·mL^(-1).MRI结果未见垂体病变,甲状腺功能无减退,其余检查未见异常。临床药师通过查阅文献,梳理患者所用药物,分析可能与奥美拉唑相关,建议临床医生停用奥美拉唑。医师采纳药师建议,停药1周后,患者泌乳症状消失,泌乳素恢复正常,后患者病情平稳出院。

A 15-year-old female patient was admitted to the hospital due to status epileptics.After admission,autoimmune antibody test of cerebrospinal fluid showed that the antibody titer of anti-N-methyl-D-aspartic acid receptor(NMDAR)was 1:100,based on which she was diagnosed with anti-NMDAR encephalitis.Impact treatment with methylprednisolone(1 g·d^(-1))was given to her combined with omeprazole enteric-coated capsules(20 mg,bid,nasal feeding)to prevent stress ulcers caused by high doses of hormones.On the 9^(th) day of admission,she developed lactation in both breasts,two days of the menstrual cycle with little amount.The level of serum prolactin was 36.69 ng·mL^(-1).There were no abnormal findings in pituitary in craniocerebral MRI,thyroid function and other examinations.Clinical pharmacists considered lactation associated with omeprazole after reviewing the literature and analyzing the drugs taken by the patient.And then omeprazole was stopped advised by clinical pharmacists.One week later,the lactation disappeared,and the level of serum prolactin returned to normal.She was discharged in a stable condition.